Provider Demographics
NPI:1407108566
Name:NEWMAN, ROBERT (PHD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:
Last Name:NEWMAN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 WEST PARK AVENUE
Mailing Address - Street 2:OFFICE 210B
Mailing Address - City:LONG BEACH
Mailing Address - State:NY
Mailing Address - Zip Code:11561
Mailing Address - Country:US
Mailing Address - Phone:516-448-5042
Mailing Address - Fax:516-608-4092
Practice Address - Street 1:100 W PARK AVE
Practice Address - Street 2:OFFICE 210B
Practice Address - City:LONG BEACH
Practice Address - State:NY
Practice Address - Zip Code:11561-3302
Practice Address - Country:US
Practice Address - Phone:516-448-5042
Practice Address - Fax:516-608-4092
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-12
Last Update Date:2012-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1-00-0171103K00000X
NY013879-1103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst