Provider Demographics
NPI:1902939317
Name:NEWMARK, JOSEPH M (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:M
Last Name:NEWMARK
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Gender:M
Credentials:MD
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Mailing Address - Street 1:4104 VESTAL RD
Mailing Address - Street 2:VESTAL EXECUTIVE PARK SUITE 203
Mailing Address - City:VESTAL
Mailing Address - State:NY
Mailing Address - Zip Code:13850-3500
Mailing Address - Country:US
Mailing Address - Phone:607-797-9036
Mailing Address - Fax:607-798-0601
Practice Address - Street 1:4104 VESTAL RD
Practice Address - Street 2:VESTAL EXECUTIVE PARK SUITE 203
Practice Address - City:VESTAL
Practice Address - State:NY
Practice Address - Zip Code:13850-3500
Practice Address - Country:US
Practice Address - Phone:607-797-9036
Practice Address - Fax:607-798-0601
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-14
Last Update Date:2011-03-11
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Provider Licenses
StateLicense IDTaxonomies
NY147249207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYB82723Medicare UPIN