MEDICARE: DR. LINDA LEE NEWMARK PHD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist	0515	AZ

General Provider Information

NPI Number	:	1275758179
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LINDA LEE NEWMARK PHD

Provider Business Mailing Address
First Line	:	4835 E PLACITA ABREVADERO
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85712-1253
Country	:	US
Telephone Number	:	520-577-7660
Fax Number	:	520-577-6474

Provider Business Practice Location Address
First Line	:	4835 E PLACITA ABREVADERO
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85712-1253
Country	:	US
Telephone Number	:	520-577-7660
Fax Number	:	520-577-6474

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/16/2007
Last Update Date	:	07/08/2007

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