Provider Demographics
NPI:1053440974
Name:NEWTON, JEFFREY HOLMES (MD)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:HOLMES
Last Name:NEWTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 VICTORIA TER
Mailing Address - Street 2:
Mailing Address - City:GOSHEN
Mailing Address - State:NY
Mailing Address - Zip Code:10924-2205
Mailing Address - Country:US
Mailing Address - Phone:845-294-7933
Mailing Address - Fax:
Practice Address - Street 1:7 COATES DR
Practice Address - Street 2:SUITE 4A
Practice Address - City:GOSHEN
Practice Address - State:NY
Practice Address - Zip Code:10924-6748
Practice Address - Country:US
Practice Address - Phone:845-294-6125
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-05
Last Update Date:2012-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY120153-12084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY120153-2BOtherWORKERS COMP. BOARD NO.
NY120153-2BOtherWORKERS COMP. BOARD NO.
NYD39065Medicare UPIN