MEDICARE: BERNARD NEWMAN

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	174400000X	Specialist	25MA05448200	NJ
2	207XS0117X	Orthopaedic Surgery of the Spine Physician	25MA05448200	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	200019954	OTHER	NJ	RR MDCR #

General Provider Information

NPI Number	:	1316931744
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BERNARD NEWMAN

Provider Business Mailing Address
First Line	:	680 KINDERKAMACK RD STE 300
Second Line	:
City	:	ORADELL
State	:	NJ
Zip	:	07649-1600
Country	:	US
Telephone Number	:	201-342-2550
Fax Number	:	201-342-7171

Provider Business Practice Location Address
First Line	:	680 KINDERKAMACK RD STE 300
Second Line	:
City	:	ORADELL
State	:	NJ
Zip	:	07649-1600
Country	:	US
Telephone Number	:	201-342-2550
Fax Number	:	201-342-7171

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

Provider Enumeration Date	:	08/31/2005
Last Update Date	:	06/03/2020

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Directions to “ BERNARD NEWMAN ” Practice Location

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