Provider Demographics
NPI:1033782693
Name:NEWMARK, SHIRA (MSED)
Entity Type:Individual
Prefix:MS
First Name:SHIRA
Middle Name:
Last Name:NEWMARK
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 CREEK DR APT 201
Mailing Address - Street 2:
Mailing Address - City:BEACON
Mailing Address - State:NY
Mailing Address - Zip Code:12508-3476
Mailing Address - Country:US
Mailing Address - Phone:347-623-6521
Mailing Address - Fax:
Practice Address - Street 1:7 CREEK DR APT 201
Practice Address - Street 2:
Practice Address - City:BEACON
Practice Address - State:NY
Practice Address - Zip Code:12508-3476
Practice Address - Country:US
Practice Address - Phone:347-623-6521
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-21
Last Update Date:2021-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist