Healthcare Provider Details

I. General information

NPI: 1437289451
Provider Name (Legal Business Name): DR JAY R NEWMAN PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/07/2007
Last Update Date: 01/22/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15340 JOG RD STE 205
DELRAY BEACH FL
33446-2170
US

IV. Provider business mailing address

15340 JOG ROAD SUITE 205
DELRAY BEACH FL
33446-0000
US

V. Phone/Fax

Practice location:
  • Phone: 561-638-7600
  • Fax: 561-638-6787
Mailing address:
  • Phone: 561-638-7600
  • Fax: 561-638-6787

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberPO2131
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code213ER0200X
TaxonomyRadiology Podiatrist
License NumberPO 2131
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License NumberPO 2131
License Number StateFL
# 4
Primary TaxonomyY
Taxonomy Code213EP1101X
TaxonomyPrimary Podiatric Medicine Podiatrist
License NumberPO 2131
License Number StateFL

VIII. Authorized Official

Name: DR. JAY R NEWMAN
Title or Position: CEO
Credential: DPM
Phone: 561-638-7600