Healthcare Provider Details

I. General information

NPI: 1669596409
Provider Name (Legal Business Name): NEWTOWN CENTER PEDIATRICS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/19/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 QUEEN ST
NEWTOWN CT
06470-2122
US

IV. Provider business mailing address

10 QUEEN ST
NEWTOWN CT
06470-2122
US

V. Phone/Fax

Practice location:
  • Phone: 203-426-3267
  • Fax: 203-426-3909
Mailing address:
  • Phone: 203-426-3267
  • Fax: 203-426-3909

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number037535
License Number StateCT

VIII. Authorized Official

Name: DR. RICHARD J AUERBACH
Title or Position: MEMBER, NCP LLC
Credential: MD
Phone: 203-426-3267