Provider Demographics
NPI:1952475683
Name:NEW LIFE PLUS, PC
Entity Type:Organization
Organization Name:NEW LIFE PLUS, PC
Other - Org Name:WOMENS HEALTH & WELLNESS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:HALL
Authorized Official - Last Name:MCCRAVEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:203-272-1990
Mailing Address - Street 1:1781 HIGHLAND AVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:CHESHIRE
Mailing Address - State:CT
Mailing Address - Zip Code:06410-1254
Mailing Address - Country:US
Mailing Address - Phone:203-272-1990
Mailing Address - Fax:202-271-0668
Practice Address - Street 1:1781 HIGHLAND AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:CHESHIRE
Practice Address - State:CT
Practice Address - Zip Code:06410-1254
Practice Address - Country:US
Practice Address - Phone:203-272-1990
Practice Address - Fax:202-271-0668
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Not Answered207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT2170777OtherAETNA
CT4194445Medicaid
CTP1400760OtherOXFORD
CT50NEWLIFECT01OtherBLUE SHIELD
CT=========OtherCONNECTICARE
CT4194445Medicaid
CT=========OtherCONNECTICARE