Provider Demographics
NPI:1508173337
Name:NEWMAN, JOHN D (CRNA)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:D
Last Name:NEWMAN
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:40 FRONT ST. SUITE C
Mailing Address - Street 2:RIVERSIDE ASSOCIATES IN ANESTHESIA
Mailing Address - City:BINGHAMTON
Mailing Address - State:NY
Mailing Address - Zip Code:13905
Mailing Address - Country:US
Mailing Address - Phone:607-722-7264
Mailing Address - Fax:607-722-7869
Practice Address - Street 1:169 RIVERSIDE DR.
Practice Address - Street 2:OUR LADY OF LOURDES HOSPITAL
Practice Address - City:BINGHAMTON
Practice Address - State:NY
Practice Address - Zip Code:13905
Practice Address - Country:US
Practice Address - Phone:607-722-7264
Practice Address - Fax:607-722-7869
Is Sole Proprietor?:No
Enumeration Date:2010-08-31
Last Update Date:2011-03-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY580000-1163W00000X
NY085429367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse