=====================================================
General NPI Number Information
=====================================================
NPI Number | 1528940939
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | NEWTRO SC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/24/2025
-----------------------------------------------------
Last Update Date | 03/13/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 410 W FRANKLIN ST # 507
-----------------------------------------------------
City | APPLETON
-----------------------------------------------------
State | WI
-----------------------------------------------------
Zip | 54911-4625
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 346-347-1673
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 410 W FRANKLIN ST # 507
-----------------------------------------------------
City | APPLETON
-----------------------------------------------------
State | WI
-----------------------------------------------------
Zip | 54911-4625
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRACTICE DIRECTOR
-----------------------------------------------------
Name | NICKOLAS LEWIS
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 920-621-6897
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QX0203X
-----------------------------------------------------
Taxonomy Name | Radiation Oncology Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------