Healthcare Provider Details
I. General information
NPI: 1578549101
Provider Name (Legal Business Name): STEPHEN MARK NEWMAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 12/15/2005
Last Update Date: 12/28/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
824 OLD COUNTRY RD
PLAINVIEW NY
11803-4950
US
IV. Provider business mailing address
824 OLD COUNTRY RD
PLAINVIEW NY
11803-4950
US
V. Phone/Fax
- Phone: 516-822-2230
- Fax: 516-822-0163
- Phone: 516-822-2230
- Fax: 516-822-0163
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084N0400X |
| Taxonomy | Neurology Physician |
| License Number | 116328 |
| License Number State | NY |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
| # 1 | |
| Identifier | 4203312 |
| Identifier Type | OTHER |
| Identifier State | NY |
| Identifier Issuer | AETNA |
| # 2 | |
| Identifier | AS408 |
| Identifier Type | OTHER |
| Identifier State | NY |
| Identifier Issuer | OXFORD |
| # 3 | |
| Identifier | 130003942 |
| Identifier Type | OTHER |
| Identifier State | NY |
| Identifier Issuer | RR MEDICARE |
| # 4 | |
| Identifier | 289791 |
| Identifier Type | OTHER |
| Identifier State | NY |
| Identifier Issuer | EMPIRE BLUE CROSS |
| # 5 | |
| Identifier | 0093475 |
| Identifier Type | OTHER |
| Identifier State | NY |
| Identifier Issuer | AETNA USHC |
| # 6 | |
| Identifier | 0229747-011 |
| Identifier Type | OTHER |
| Identifier State | NY |
| Identifier Issuer | CIGNA |
| # 7 | |
| Identifier | 593342 |
| Identifier Type | OTHER |
| Identifier State | NY |
| Identifier Issuer | UNITED HEALTHCARE |
| # 8 | |
| Identifier | 00397104 |
| Identifier Type | MEDICAID |
| Identifier State | NY |
| Identifier Issuer | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: