Provider Demographics
NPI:1932592441
Name:NEW PROVIDENCE HEALTHCARE ASSOCIATES INC.
Entity Type:Organization
Organization Name:NEW PROVIDENCE HEALTHCARE ASSOCIATES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/MEDICAL DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHANIQUE
Authorized Official - Middle Name:
Authorized Official - Last Name:CARTWRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-633-3175
Mailing Address - Street 1:5627 ALLENTOWN RD
Mailing Address - Street 2:UNIT 100
Mailing Address - City:CAMP SPRINGS
Mailing Address - State:MD
Mailing Address - Zip Code:20746-4520
Mailing Address - Country:US
Mailing Address - Phone:301-241-0255
Mailing Address - Fax:240-455-0247
Practice Address - Street 1:145 FLEET ST STE 136
Practice Address - Street 2:C/O NEW PROVIDENCE HEALTHCARE ASSOCIATES INC.
Practice Address - City:OXON HILL
Practice Address - State:MD
Practice Address - Zip Code:20745-1548
Practice Address - Country:US
Practice Address - Phone:301-899-8910
Practice Address - Fax:301-899-8915
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-07
Last Update Date:2018-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDMD00726642084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Multi-Specialty