Provider Demographics
NPI:1164431490
Name:NEWMAN, FREDERIC ROBERT (MD)
Entity Type:Individual
Prefix:MR
First Name:FREDERIC
Middle Name:ROBERT
Last Name:NEWMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 MERCER ST.
Mailing Address - Street 2:APT #B604
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003
Mailing Address - Country:US
Mailing Address - Phone:212-533-1199
Mailing Address - Fax:973-423-5643
Practice Address - Street 1:303 MERCER ST
Practice Address - Street 2:APT # B604
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003
Practice Address - Country:US
Practice Address - Phone:973-423-4400
Practice Address - Fax:973-423-5643
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-05
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY111093207W00000X
NJMA033898207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ441183589OtherRAILROAD MEDICARE
NJ199977OtherAMERIHEALTH PPO
NJ4405573OtherAETNA
NJPS028OtherOXFORD
NJ0092078000OtherAMERIHEALTH HMO
NJ41231OtherUS HEALTHCARE
NJ0000729OtherGHI
NJ0K7443OtherHEALTH NET
NJ29572OtherEMPIRE BS
NJ0727601Medicaid
NJ29572OtherEMPIRE BS
NJ4405573OtherAETNA