Healthcare Provider Details

I. General information

NPI: 1164593984
Provider Name (Legal Business Name): DONNA W. NEWSOME M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/13/2006
Last Update Date: 04/02/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

47 NEW SCOTLAND AVE MC 164
ALBANY NY
12208-3412
US

IV. Provider business mailing address

162 FOREST HILL DR
KINGSTON NY
12401-7461
US

V. Phone/Fax

Practice location:
  • Phone: 518-262-5511
  • Fax:
Mailing address:
  • Phone: 845-340-4000
  • Fax: 845-340-4094

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number201924-1
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number201924-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: