Provider Demographics
NPI:1528940939
Name:NEWTRO SC
Entity type:Organization
Organization Name:NEWTRO SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LAURIE
Authorized Official - Middle Name:
Authorized Official - Last Name:FENSTERMACHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:346-347-1673
Mailing Address - Street 1:410 W FRANKLIN ST # 507
Mailing Address - Street 2:
Mailing Address - City:APPLETON
Mailing Address - State:WI
Mailing Address - Zip Code:54911-4625
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:410 W FRANKLIN ST # 507
Practice Address - Street 2:
Practice Address - City:APPLETON
Practice Address - State:WI
Practice Address - Zip Code:54911-4625
Practice Address - Country:US
Practice Address - Phone:346-347-1673
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-24
Last Update Date:2025-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QX0203XAmbulatory Health Care FacilitiesClinic/CenterOncology, RadiationGroup - Single Specialty