Provider Demographics
NPI:1386640142
Name:NEWMAN, ANDREW B (PA-C)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:B
Last Name:NEWMAN
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:931 E HAVERFORD RD
Mailing Address - Street 2:STE 202
Mailing Address - City:BRYN MAWR
Mailing Address - State:PA
Mailing Address - Zip Code:19010-3838
Mailing Address - Country:US
Mailing Address - Phone:610-525-8200
Mailing Address - Fax:610-525-8201
Practice Address - Street 1:931 EAST HAVERFORD RD
Practice Address - Street 2:STE 202
Practice Address - City:BRYN MAWR
Practice Address - State:PA
Practice Address - Zip Code:19010
Practice Address - Country:US
Practice Address - Phone:610-525-8200
Practice Address - Fax:610-525-8201
Is Sole Proprietor?:No
Enumeration Date:2005-06-24
Last Update Date:2014-09-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMA901131L363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
S79556Medicare UPIN
PA085318Medicare ID - Type Unspecified