Healthcare Provider Details

I. General information

NPI: 1063587772
Provider Name (Legal Business Name): NEWABILITIES SYSTEMS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/21/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2938 SCOTT BLVD
SANTA CLARA CA
95054-3312
US

IV. Provider business mailing address

2938 SCOTT BLVD
SANTA CLARA CA
95054-3312
US

V. Phone/Fax

Practice location:
  • Phone: 408-988-9969
  • Fax: 408-988-9979
Mailing address:
  • Phone: 408-988-9969
  • Fax: 408-988-9979

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332900000X
TaxonomyNon-Pharmacy Dispensing Site
License Number4374
License Number StateAZ

VIII. Authorized Official

Name: ROBERT JAGUNICH
Title or Position: PRESIDENT
Credential:
Phone: 408-988-9969