Healthcare Provider Details

I. General information

NPI: 1013060508
Provider Name (Legal Business Name): LISA G NEWMAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/19/2007
Last Update Date: 02/28/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

317 E 17TH ST 7TH FLOOR
NEW YORK NY
10003-3804
US

IV. Provider business mailing address

PO BOX 95000-2433
PHILADELPHIA PA
19195-2433
US

V. Phone/Fax

Practice location:
  • Phone: 212-844-1475
  • Fax: 212-420-2224
Mailing address:
  • Phone: 212-844-1475
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number166660
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: