MEDICARE: DR. LAURA JEAN NEWMAN 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	014285	NY

General Provider Information

NPI Number	:	1336102656
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LAURA JEAN NEWMAN PHD

Provider Business Mailing Address
First Line	:	3321 73RD ST
Second Line	:
City	:	JACKSON HEIGHTS
State	:	NY
Zip	:	11372-1105
Country	:	US
Telephone Number	:	646-239-5615
Fax Number	:

Provider Business Practice Location Address
First Line	:	3321 73RD ST
Second Line	:
City	:	JACKSON HEIGHTS
State	:	NY
Zip	:	11372-1105
Country	:	US
Telephone Number	:	646-239-5615
Fax Number	:

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

Provider Enumeration Date	:	04/08/2006
Last Update Date	:	06/27/2013

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