1497985402 NPI number — NEWMAN CHIROPRACTIC, PC

Table of content: (NPI 1497985402)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1497985402 NPI number — NEWMAN CHIROPRACTIC, PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NEWMAN CHIROPRACTIC, PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1497985402
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/19/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2090 GREENTREE RD
Provider Second Line Business Mailing Address:
SUITE 100
Provider Business Mailing Address City Name:
PITTSBURGH
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15220-1403
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
412-489-5812
Provider Business Mailing Address Fax Number:
412-489-6081

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2090 GREENTREE RD
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
PITTSBURGH
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15220-1403
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-489-5812
Provider Business Practice Location Address Fax Number:
412-489-6081
Provider Enumeration Date:
07/24/2009

Additional Information

Authorized Official

Authorized Official Last Name:
HENN
Authorized Official First Name:
LISA
Authorized Official Middle Name:
L
Authorized Official Title or Position:
OFFICE MANAGER
Authorized Official Telephone Number:
412-489-5812

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1011768162002 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1012696930001 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1021161150002 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0010513270001 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0019444200002 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1016947310002 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1022972530001 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0017708400001 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".




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