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General NPI Number Information
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NPI Number | 1396317947
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Entity Type | Organization
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Legal Business Name | HALEY A. NEWSTROM, O.D., P.A.
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Dates
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Enumeration Date | 07/13/2021
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Last Update Date | 07/13/2021
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Provider Practice Location Address
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Address Line | 650 N CONGRESS AVE
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City | BOYNTON BEACH
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State | FL
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Zip | 33426-3445
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Country | US
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Telephone | 561-752-9779
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Fax |
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Provider Business Mailing Address
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Address Line | 60 NW 35TH ST
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City | OAKLAND PARK
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State | FL
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Zip | 33309-5202
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | DR. HALEY NEWSTROM
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Credential | O.D.
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Telephone | 954-235-8870
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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