Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 106627 | NY |
NPI | 1023115037 |
---|---|
Provider Name | John C Newman |
First Address | Niagara Falls, NY 14304-3071 |
Second Address | Niagara Falls, NY 14304-3071 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00503984 | (05) | NY |
D01425 | (02) | NY |