Provider Demographics
NPI:1487693347
Name:FAMILY PRACTICE CENTER OF NEWTOWN
Entity type:Organization
Organization Name:FAMILY PRACTICE CENTER OF NEWTOWN
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:M
Authorized Official - Last Name:GULAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-968-1616
Mailing Address - Street 1:638 NEWTOWN YARDLEY RD
Mailing Address - Street 2:SUITE 2E
Mailing Address - City:NEWTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18940-1758
Mailing Address - Country:US
Mailing Address - Phone:215-968-1616
Mailing Address - Fax:215-860-1976
Practice Address - Street 1:638 NEWTOWN YARDLEY RD
Practice Address - Street 2:SUITE 2E
Practice Address - City:NEWTOWN
Practice Address - State:PA
Practice Address - Zip Code:18940-1758
Practice Address - Country:US
Practice Address - Phone:215-968-1616
Practice Address - Fax:215-860-1976
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS006923L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA665612Medicare ID - Type Unspecified
PAF00341Medicare UPIN