Provider Demographics
NPI:1538454251
Name:NEWMAN, MINDY
Entity type:Individual
Prefix:
First Name:MINDY
Middle Name:
Last Name:NEWMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:76 FRANKLIN AVE
Mailing Address - Street 2:REAR
Mailing Address - City:OCEAN GROVE
Mailing Address - State:NJ
Mailing Address - Zip Code:07756-1118
Mailing Address - Country:US
Mailing Address - Phone:917-583-2264
Mailing Address - Fax:
Practice Address - Street 1:928 BROADWAY STE 1200
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-8106
Practice Address - Country:US
Practice Address - Phone:917-583-2264
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-10
Last Update Date:2015-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health