Provider Demographics
NPI:1538388673
Name:NEWMAN, ANN H (NURSE PRACTITIONER)
Entity type:Individual
Prefix:MS
First Name:ANN
Middle Name:H
Last Name:NEWMAN
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8351 STATE ROUTE 415
Mailing Address - Street 2:
Mailing Address - City:CAMPBELL
Mailing Address - State:NY
Mailing Address - Zip Code:14821-9536
Mailing Address - Country:US
Mailing Address - Phone:607-527-8810
Mailing Address - Fax:
Practice Address - Street 1:48 COLONIAL DR
Practice Address - Street 2:
Practice Address - City:HORSEHEADS
Practice Address - State:NY
Practice Address - Zip Code:14845-8532
Practice Address - Country:US
Practice Address - Phone:607-739-0304
Practice Address - Fax:607-796-0540
Is Sole Proprietor?:No
Enumeration Date:2007-04-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY330159363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYD81091Medicare ID - Type UnspecifiedMCA B - ELCOR PMT GROUP
NYB83183Medicare UPIN