Healthcare Provider Details

I. General information

NPI: 1326367665
Provider Name (Legal Business Name): NEW BEGINNINGS PEDIATRICS, PLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/26/2010
Last Update Date: 05/29/2024
Certification Date: 05/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18699 N 67TH AVE 240
GLENDALE AZ
85308-7140
US

IV. Provider business mailing address

18699 N 67TH AVE 240
GLENDALE AZ
85308-7140
US

V. Phone/Fax

Practice location:
  • Phone: 623-594-7337
  • Fax: 623-594-7340
Mailing address:
  • Phone: 623-594-7337
  • Fax: 623-594-7340

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number34314
License Number StateAZ

VIII. Authorized Official

Name: DR. AASHIMA BANSAL
Title or Position: PEDIATRICIAN
Credential: M.D.
Phone: 585-732-1770