Provider Demographics
NPI:1063683555
Name:PHILIP NEWMAN, D.P.M.
Entity Type:Organization
Organization Name:PHILIP NEWMAN, D.P.M.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR-OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:STEWEART
Authorized Official - Last Name:NEWMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:908-231-1114
Mailing Address - Street 1:201 UNION AVE
Mailing Address - Street 2:BUILDING 1, SUITE C
Mailing Address - City:BRIDGEWATER
Mailing Address - State:NJ
Mailing Address - Zip Code:08807-3002
Mailing Address - Country:US
Mailing Address - Phone:908-231-1114
Mailing Address - Fax:908-252-1930
Practice Address - Street 1:201 UNION AVE
Practice Address - Street 2:BUILDING 1, SUITE C
Practice Address - City:BRIDGEWATER
Practice Address - State:NJ
Practice Address - Zip Code:08807-3002
Practice Address - Country:US
Practice Address - Phone:908-231-1114
Practice Address - Fax:908-252-1930
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-12
Last Update Date:2008-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MD000160100332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0653680001Medicare NSC