Healthcare Provider Details

I. General information

NPI: 1841591427
Provider Name (Legal Business Name): ROBERT S NEWMAN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/12/2010
Last Update Date: 11/12/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 MEADOW RUE LN
E NORTHPORT NY
11731-4725
US

IV. Provider business mailing address

1 MEADOW RUE LN
EAST NORTHPORT NY
11731-4725
US

V. Phone/Fax

Practice location:
  • Phone: 631-368-6320
  • Fax: 631-368-2925
Mailing address:
  • Phone: 631-368-6320
  • Fax: 631-368-2925

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberX2679
License Number StateNY

VIII. Authorized Official

Name: DR. ROBERT S NEWMAN
Title or Position: PRESIDENT
Credential: DC
Phone: 631-368-6320