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General NPI Number Information
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NPI Number | 1811246762
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Entity Type | Organization
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Legal Business Name | NEWCOURTLAND LIFE
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Dates
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Enumeration Date | 09/06/2012
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Last Update Date | 09/06/2012
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Provider Practice Location Address
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Address Line | 6950 GERMANTOWN AVENUE
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City | PHILADELPHIA
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State | PA
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Zip | 19119
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Country | US
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Telephone | 215-951-4416
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Fax | 215-848-2627
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Provider Business Mailing Address
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Address Line | 516 CANTERBURY ROAD
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City | JEFFERSONVILLE
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State | PA
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Zip | 19403
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Country | US
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Telephone | 610-608-2463
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Fax |
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Authorized Official
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Title or Position | SOCIAL WORKER
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Name | MRS. JILL E KLEPPINGER
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Credential | LSW
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Telephone | 610-608-2463
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number | SW125047
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License Number State | PA
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