Provider Demographics
NPI:1043386576
Name:NEWHOUSE, JEANNE PANCAMO (NCPSYA)
Entity Type:Individual
Prefix:MS
First Name:JEANNE
Middle Name:PANCAMO
Last Name:NEWHOUSE
Suffix:
Gender:F
Credentials:NCPSYA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:680 W END AVE
Mailing Address - Street 2:SUITE 1A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-6815
Mailing Address - Country:US
Mailing Address - Phone:212-866-3669
Mailing Address - Fax:
Practice Address - Street 1:680 W END AVE
Practice Address - Street 2:SUITE 1A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-6815
Practice Address - Country:US
Practice Address - Phone:212-866-3669
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000451-1174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist