Provider Demographics
NPI:1457322034
Name:NEWALL, JANET FAY (MSN, CNM)
Entity Type:Individual
Prefix:MRS
First Name:JANET
Middle Name:FAY
Last Name:NEWALL
Suffix:
Gender:F
Credentials:MSN, CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:908 NIAGARA FALLS BLVD
Mailing Address - Street 2:STE 208
Mailing Address - City:N TONAWANDA
Mailing Address - State:NY
Mailing Address - Zip Code:14120-2019
Mailing Address - Country:US
Mailing Address - Phone:716-692-2160
Mailing Address - Fax:716-692-4342
Practice Address - Street 1:2157 MAIN ST
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14214-2648
Practice Address - Country:US
Practice Address - Phone:716-862-1501
Practice Address - Fax:716-213-0348
Is Sole Proprietor?:No
Enumeration Date:2006-01-31
Last Update Date:2007-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF001197-1367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY000929673001OtherHEALTHNOW NY INC
NY0129688OtherGHI PPO
NY2607468OtherUNITEDHEALTHCARE ID
PA1015216040001Medicaid
NY1200880OtherAETNA ID NUMBER
NY02733388Medicaid
NY1200880OtherAETNA ID NUMBER
PA1015216040001Medicaid