Healthcare Provider Details

I. General information

NPI: 1295821940
Provider Name (Legal Business Name): HAROLD K NEWMAN PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7213 RAYMOND DR NE
ALBUQUERQUE NM
87109
US

IV. Provider business mailing address

4801 LANG AVE NE SUITE 110
ALBUQUERQUE NM
87109-4475
US

V. Phone/Fax

Practice location:
  • Phone: 505-856-2768
  • Fax: 505-856-2768
Mailing address:
  • Phone: 505-994-2375
  • Fax: 505-994-2373

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number0864
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: