Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0117X | Orthopaedic Spine Surgeon | 25MA05448200 | NJ |
NPI | 1316931744 |
---|---|
Provider Name | Bernard Newman |
First Address | Oradell, NJ 07649-1600 |
Second Address | Oradell, NJ 07649-1600 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2005 |
Last Update Date | 03/06/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200019954 | RR MDCR # (01) | NJ |
E53725 | (02) | NJ |