Provider Demographics
NPI:1285939579
Name:NEWPORT FAMILY PRACTICE PC
Entity type:Organization
Organization Name:NEWPORT FAMILY PRACTICE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LOUISE
Authorized Official - Middle Name:
Authorized Official - Last Name:SAUSMAN
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:717-567-3151
Mailing Address - Street 1:52 RED HILL CT
Mailing Address - Street 2:
Mailing Address - City:NEWPORT
Mailing Address - State:PA
Mailing Address - Zip Code:17074-8706
Mailing Address - Country:US
Mailing Address - Phone:717-567-3151
Mailing Address - Fax:717-567-7571
Practice Address - Street 1:52 RED HILL CT
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:PA
Practice Address - Zip Code:17074-8706
Practice Address - Country:US
Practice Address - Phone:717-567-3151
Practice Address - Fax:717-567-7571
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-18
Last Update Date:2016-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty