MEDICARE: DR. KENNETH NEWMAN MD

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	207L00000X	Anesthesiology Physician	196313	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1609868355
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KENNETH NEWMAN MD

Provider Business Mailing Address
First Line	:	40 DELANO DR
Second Line	:
City	:	RHINEBECK
State	:	NY
Zip	:	12572
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	160 EAST MAIN STREET
Second Line	:	ANESTHESIA DEPT
City	:	PORT JERVIS
State	:	NY
Zip	:	12771-2253
Country	:	US
Telephone Number	:	845-357-5775
Fax Number	:	845-357-5777

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

Provider Enumeration Date	:	08/18/2005
Last Update Date	:	08/31/2018

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