Healthcare Provider Details

I. General information

NPI: 1376563502
Provider Name (Legal Business Name): IAN HOWARD NEWMARK M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/20/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8 GREENFIELD RD
SYOSSET NY
11791-4831
US

IV. Provider business mailing address

8 GREENFIELD RD
SYOSSET NY
11791-4831
US

V. Phone/Fax

Practice location:
  • Phone: 516-496-7900
  • Fax: 516-496-2139
Mailing address:
  • Phone: 516-496-7900
  • Fax: 516-496-2139

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number142572
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: