Healthcare Provider Details

I. General information

NPI: 1861449480
Provider Name (Legal Business Name): AARON N. NEWBERG M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/28/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1939 W CHELTENHAM AVE
ELKINS PARK PA
19027-1046
US

IV. Provider business mailing address

1866 FOOTHILL DR
HUNTINGDON VALLEY PA
19006-7920
US

V. Phone/Fax

Practice location:
  • Phone: 215-924-6667
  • Fax: 215-884-1442
Mailing address:
  • Phone: 215-947-6789
  • Fax: 215-677-6706

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD006707E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: