# AFFINITY HEALTHCARE GROUP NEWTOWN LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1164814612
- **Authorized official:** MR. RONALD A MARTIN JR. (REGIONAL DIRECTOR)
- **Authorized official phone:** (757) 962-0748

## Contact information

- **Practice address:** 5715 PRINCESS ANNE RD, \#106-107, VIRGINIA BEACH, VA 23462-3222
- **Practice address phone:** (757) 962-0748
- **Practice address fax:** (757) 962-0876
- **Mailing address:** 5715 PRINCESS ANNE RD, \#106-107, VIRGINIA BEACH, VA 23462-3222
- **Mailing address phone:** (757) 962-0748
- **Mailing address fax:** (757) 962-0876

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 0102201920 | VA | Yes |
| 207QA0401X | Addiction Medicine (Family Medicine) Physician | 207QA0401X | VA | — |

## Other

- **Enumeration date:** 02/20/2015
- **Last updated:** 11/17/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | F092 | MEDICARE PTAN | VA |