MEDICARE: NEW LIFE CARDIOVASCULAR CARE, P.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	207R00000X	Internal Medicine Physician
2	261QP2300X	Primary Care Clinic/Center
3	261QR0200X	Radiology Clinic/Center
4	207RC0000X	Cardiovascular Disease Physician

General Provider Information

NPI Number	:	1205983491
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEW LIFE CARDIOVASCULAR CARE, P.C.

Provider Business Mailing Address
First Line	:	805 E WILLOW GROVE AVE # 19038
Second Line	:
City	:	WYNDMOOR
State	:	PA
Zip	:	19038-7968
Country	:	US
Telephone Number	:	215-966-1546
Fax Number	:	215-764-5472

Provider Business Practice Location Address
First Line	:	805 E WILLOW GROVE AVE # 19038
Second Line	:
City	:	GLENSIDE
State	:	PA
Zip	:	19038-7968
Country	:	US
Telephone Number	:	215-966-1546
Fax Number	:	215-764-5472

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MICHAEL W MILBOURNE
Credential	:	MD
Telephone Number	:	215-966-1546

Provider Enumeration Date	:	01/03/2007
Last Update Date	:	03/29/2024

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