Provider Demographics
NPI:1134536238
Name:NEWCOMER, KRISTINA MARIE (DO)
Entity type:Individual
Prefix:DR
First Name:KRISTINA
Middle Name:MARIE
Last Name:NEWCOMER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:KRISTINA
Other - Middle Name:MARIE
Other - Last Name:NEWCOMER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DO
Mailing Address - Street 1:496 SHELLEYS LN
Mailing Address - Street 2:
Mailing Address - City:ETTERS
Mailing Address - State:PA
Mailing Address - Zip Code:17319-9412
Mailing Address - Country:US
Mailing Address - Phone:717-938-6040
Mailing Address - Fax:
Practice Address - Street 1:496 SHELLEYS LN
Practice Address - Street 2:
Practice Address - City:ETTERS
Practice Address - State:PA
Practice Address - Zip Code:17319-9412
Practice Address - Country:US
Practice Address - Phone:717-938-6040
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-21
Last Update Date:2014-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS008049207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine