Provider Demographics
NPI:1932254711
Name:FAMILY CARE ASSOCIATES OF NEW CASTLE PC
Entity Type:Organization
Organization Name:FAMILY CARE ASSOCIATES OF NEW CASTLE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:AMELITA
Authorized Official - Middle Name:
Authorized Official - Last Name:MAMARIL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:724-658-5437
Mailing Address - Street 1:3315 WILMINGTON RD
Mailing Address - Street 2:
Mailing Address - City:NEW CASTLE
Mailing Address - State:PA
Mailing Address - Zip Code:16105-1038
Mailing Address - Country:US
Mailing Address - Phone:724-658-5437
Mailing Address - Fax:724-658-1042
Practice Address - Street 1:3315 WILMINGTON RD
Practice Address - Street 2:
Practice Address - City:NEW CASTLE
Practice Address - State:PA
Practice Address - Zip Code:16105-1038
Practice Address - Country:US
Practice Address - Phone:724-658-5437
Practice Address - Fax:724-658-1042
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-24
Last Update Date:2007-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD050071L208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0014186740004Medicaid