MEDICARE: DANIEL M NEWCOMER DC

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	111N00000X	Chiropractor	MCO 2257	NJ

General Provider Information

NPI Number	:	1831190214
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIEL M NEWCOMER DC

Provider Business Mailing Address
First Line	:	3010 BORDENTOWN AVE
Second Line	:	SAYREBRIDGE PROF BLD
City	:	PARLIN
State	:	NJ
Zip	:	08859-1181
Country	:	US
Telephone Number	:	732-721-0044
Fax Number	:	732-316-1336

Provider Business Practice Location Address
First Line	:	3010 BORDENTOWN AVE
Second Line	:	SAYREBRIDGE PROF BLD
City	:	PARLIN
State	:	NJ
Zip	:	08859-1181
Country	:	US
Telephone Number	:	732-721-0044
Fax Number	:	732-316-1336

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

Provider Enumeration Date	:	08/09/2005
Last Update Date	:	12/18/2007

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