Healthcare Provider Details

I. General information

NPI: 1467572651
Provider Name (Legal Business Name): ORANGETOWN PEDIATRIC ASSOCIATES, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/30/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

422 WESTERN HWY
TAPPAN NY
10983-1311
US

IV. Provider business mailing address

422 WESTERN HWY
TAPPAN NY
10983-1311
US

V. Phone/Fax

Practice location:
  • Phone: 845-359-0010
  • Fax: 845-359-3414
Mailing address:
  • Phone: 845-359-0010
  • Fax: 845-359-3414

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number101931
License Number StateNY

VIII. Authorized Official

Name: DR. PHILIP NEWFIELD
Title or Position: OWNER
Credential: M.D.
Phone: 845-359-0010