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NPI Code Detail

MEDICARE: MR. NEWMAN N NIETO MHC-LP, CASAC2

MEDICARE: MR. NEWMAN N NIETO MHC-LP, CASAC2
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
1101YA0400XAddiction (Substance Use Disorder) Counselor34082NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1336617950
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. NEWMAN N NIETO MHC-LP, CASAC2
Provider Business Mailing Address
First Line : 1623 FLATBUSH AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11210-3262
Country : US
Telephone Number : 718-377-5755
Fax Number : 718-377-0752
Provider Business Practice Location Address
First Line : 1623 FLATBUSH AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11210-3262
Country : US
Telephone Number : 718-377-5755
Fax Number : 718-377-0752
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/13/2018
Last Update Date : 07/11/2022

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