Healthcare Provider Details

I. General information

NPI: 1952500092
Provider Name (Legal Business Name): NEW HEALTH P A
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/17/2007
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 CHAPMAN ST
BREWER ME
04412-1810
US

IV. Provider business mailing address

40 CHAPMAN ST
BREWER ME
04412-1810
US

V. Phone/Fax

Practice location:
  • Phone: 207-478-6506
  • Fax: 978-225-2251
Mailing address:
  • Phone: 207-478-6506
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberPT1060
License Number StateME

VIII. Authorized Official

Name: MR. DANIEL DENNIS TARDY
Title or Position: OWNER/DIRECTOR
Credential: PT
Phone: 207-478-6506