Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0131X | Foot Surgery | PO2131 | FL |
NPI | 1417026121 |
---|---|
Provider Name | Dr. Jay Robert Newman |
First Address | Delray Beach, FL 33446-2170 |
Second Address | Delray Beach, FL 33446-2170 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/11/2006 |
Last Update Date | 31/01/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
340244400 | (05) | FL |
390218800 | (05) | FL |
480028775 | RR MCR DELRAY (01) | |
480032655 | RR MCR BOYNTON (01) | |
65244 | BC (01) | |
65244 | BC BOYNTON (01) | |
N384545 | WELLCARE (01) | |
T50901 | (02) | FL |