Provider Demographics
NPI:1902882723
Name:NEWTON MEDICAL III
Entity Type:Organization
Organization Name:NEWTON MEDICAL III
Other - Org Name:TPB MEDICAL SERVICES PC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MD PART OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JORGE
Authorized Official - Middle Name:GUMABAO
Authorized Official - Last Name:BARLIN
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:518-356-7818
Mailing Address - Street 1:2727 HAMBURG STREET
Mailing Address - Street 2:NEWTON MEDICAL III
Mailing Address - City:SCHENECTADY
Mailing Address - State:NY
Mailing Address - Zip Code:12303
Mailing Address - Country:US
Mailing Address - Phone:518-356-7818
Mailing Address - Fax:518-356-8199
Practice Address - Street 1:2727 HAMBURG STREET
Practice Address - Street 2:NEWTON MEDICAL III
Practice Address - City:SCHENECTADY
Practice Address - State:NY
Practice Address - Zip Code:12303
Practice Address - Country:US
Practice Address - Phone:518-356-7818
Practice Address - Fax:518-356-8199
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY157214208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
53638DMedicare ID - Type Unspecified
B82536Medicare UPIN