Basic Information
| Provider Information | |||||||||
| NPI: | 1386972321 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | NEWPORT | ||||||||
| FirstName: | ANAMARIA | ||||||||
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| Credential: | P.A.-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 112 WHITE HORSE PIKE | ||||||||
| Address2: | |||||||||
| City: | HADDON HEIGHTS | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 080351908 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8565465353 | ||||||||
| FaxNumber: | 8565465315 | ||||||||
| Practice Location | |||||||||
| Address1: | 112 WHITE HORSE PIKE | ||||||||
| Address2: | |||||||||
| City: | HADDON HEIGHTS | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 080351908 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8565465353 | ||||||||
| FaxNumber: | 8565465315 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/03/2009 | ||||||||
| LastUpdateDate: | 11/14/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363AM0700X | 25MP00229400 | NJ | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Medical |
No ID Information.