Individual provider Active NPI

Mary O Newman, MS

  • Specialist
  • Holbrook, NY
National Provider Identifier
1962764191
Registry record updated Jun 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
1706173 Issued in NY
Practice address
1540 Carl Ave
Holbrook, NY 11741-2318
Phone
(631) 981-7809
NPI assigned
Jun 13, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 1706173 NY Primary

Addresses

Primary practice location

1540 Carl Ave
Holbrook, NY 11741-2318

Mailing address

1540 Carl Ave
Holbrook, NY 11741-2318
Phone (631) 981-7809

Other identifiers 1

IdentifierTypeStateIssuer
1706173OtherNYNEW YORK STATE SPECIAL EDUCATION SUPERVISOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
1706173NYMDSpecialist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1339545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339545600000",
    "number": "1962764191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1540 CARL AVE",
            "city": "HOLBROOK",
            "state": "NY",
            "postal_code": "117412318",
            "telephone_number": "631-981-7809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1540 CARL AVE",
            "city": "HOLBROOK",
            "state": "NY",
            "postal_code": "117412318",
            "telephone_number": "631-981-7809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEWMAN",
        "first_name": "MARY",
        "middle_name": "O",
        "name_prefix": "Mrs.",
        "credential": "MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-13",
        "last_updated": "2012-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "1706173",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEW YORK STATE SPECIAL EDUCATION SUPERVISOR",
            "identifier": "1706173",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Holbrook, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.