Healthcare Provider Details

I. General information

NPI: 1154349330
Provider Name (Legal Business Name): ANDREW O NEWTON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/17/2006
Last Update Date: 11/10/2022
Certification Date: 11/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

129 E 5TH ST
MOUNT CARMEL PA
17851-2175
US

IV. Provider business mailing address

129 E 5TH ST
MOUNT CARMEL PA
17851-2175
US

V. Phone/Fax

Practice location:
  • Phone: 570-339-1828
  • Fax: 570-554-8701
Mailing address:
  • Phone: 570-339-1828
  • Fax: 570-554-8701

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD064665 L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: