Provider Demographics
NPI:1326246463
Name:NEWMAN, STEPHEN (LPT)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:
Last Name:NEWMAN
Suffix:
Gender:M
Credentials:LPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:860 WYCKOFF AVE
Mailing Address - Street 2:A1A
Mailing Address - City:MAHWAH
Mailing Address - State:NJ
Mailing Address - Zip Code:07430-3186
Mailing Address - Country:US
Mailing Address - Phone:201-891-9008
Mailing Address - Fax:201-891-9195
Practice Address - Street 1:860 WYCKOFF AVE
Practice Address - Street 2:A1A
Practice Address - City:MAHWAH
Practice Address - State:NJ
Practice Address - Zip Code:07430-3186
Practice Address - Country:US
Practice Address - Phone:201-891-9008
Practice Address - Fax:201-891-9195
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-10
Last Update Date:2007-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00499000261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy