MEDICARE: MR. MENASHE NEWHOUSE PA

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	363AM0700X	Medical Physician Assistant	010082	NY

General Provider Information

NPI Number	:	1821174400
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MENASHE NEWHOUSE PA

Provider Business Mailing Address
First Line	:	13 ASH ST
Second Line	:
City	:	MONSEY
State	:	NY
Zip	:	10952-1621
Country	:	US
Telephone Number	:	917-751-5145
Fax Number	:	845-354-0801

Provider Business Practice Location Address
First Line	:	493 E 138TH ST
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10454-3008
Country	:	US
Telephone Number	:	718-993-2633
Fax Number	:

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

Provider Enumeration Date	:	10/27/2006
Last Update Date	:	07/08/2007

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