Provider Demographics
NPI:1093806010
Name:NEWMAN, JARED (DO)
Entity Type:Individual
Prefix:
First Name:JARED
Middle Name:
Last Name:NEWMAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1445 WHITEHORSE MERCERVILLE ROAD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:HAMILTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08619-3834
Mailing Address - Country:US
Mailing Address - Phone:609-587-6661
Mailing Address - Fax:
Practice Address - Street 1:333 FORSGATE DR
Practice Address - Street 2:SUITE 205
Practice Address - City:JAMESBURG
Practice Address - State:NJ
Practice Address - Zip Code:08831-1567
Practice Address - Country:US
Practice Address - Phone:732-521-1210
Practice Address - Fax:732-521-1239
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2022-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMB72907207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0064815Medicaid
NJ054256Medicare ID - Type Unspecified
NJ0064815Medicaid