Provider Demographics
NPI:1811246762
Name:NEWCOURTLAND LIFE
Entity type:Organization
Organization Name:NEWCOURTLAND LIFE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOCIAL WORKER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JILL
Authorized Official - Middle Name:E
Authorized Official - Last Name:KLEPPINGER
Authorized Official - Suffix:
Authorized Official - Credentials:LSW
Authorized Official - Phone:610-608-2463
Mailing Address - Street 1:516 CANTERBURY ROAD
Mailing Address - Street 2:
Mailing Address - City:JEFFERSONVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19403
Mailing Address - Country:US
Mailing Address - Phone:610-608-2463
Mailing Address - Fax:
Practice Address - Street 1:6950 GERMANTOWN AVENUE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19119
Practice Address - Country:US
Practice Address - Phone:215-951-4416
Practice Address - Fax:215-848-2627
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-06
Last Update Date:2012-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW125047302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization