Provider Demographics
NPI:1215980222
Name:NEWTOWN LASER AND EYE INSTITUTE
Entity type:Organization
Organization Name:NEWTOWN LASER AND EYE INSTITUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GUY
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:MULLIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:215-860-3400
Mailing Address - Street 1:409 EXECUTIVE DR
Mailing Address - Street 2:
Mailing Address - City:LANGHORNE
Mailing Address - State:PA
Mailing Address - Zip Code:19047-8003
Mailing Address - Country:US
Mailing Address - Phone:215-860-3400
Mailing Address - Fax:215-860-8779
Practice Address - Street 1:409 EXECUTIVE DR
Practice Address - Street 2:
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047-8003
Practice Address - Country:US
Practice Address - Phone:215-860-3400
Practice Address - Fax:215-860-8779
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-19
Last Update Date:2016-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
No152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA575910OtherBC/BS
NJDA1790OtherRAILROAD MEDICARE
PA2129761OtherAETNA
NJ5224761OtherAETNA
PA0366355000OtherKEYSTONE
NJ104386Medicare PIN
PA042100Medicare PIN