MEDICARE: MRS. RACHEL COREY NEWMAN MSED

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TS0200X	School Psychologist	2622133	NY

General Provider Information

NPI Number	:	1235963505
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. RACHEL COREY NEWMAN MSED

Provider Business Mailing Address
First Line	:	15 FRANKLIN PL APT 15
Second Line	:
City	:	OCEANSIDE
State	:	NY
Zip	:	11572-1351
Country	:	US
Telephone Number	:	516-551-8313
Fax Number	:

Provider Business Practice Location Address
First Line	:	15 FRANKLIN PL APT 15
Second Line	:
City	:	OCEANSIDE
State	:	NY
Zip	:	11572-1351
Country	:	US
Telephone Number	:	516-551-8313
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/29/2024
Last Update Date	:	09/17/2024

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