Provider Demographics
NPI:1518398361
Name:NEWTON, DAVID WILKENSON (ACNP)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:WILKENSON
Last Name:NEWTON
Suffix:
Gender:M
Credentials:ACNP
Other - Prefix:DR
Other - First Name:RONAK
Other - Middle Name:NARESH
Other - Last Name:CHINAI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:4 WESTMINSTER LN
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07305-1423
Mailing Address - Country:US
Mailing Address - Phone:818-961-5023
Mailing Address - Fax:201-547-8355
Practice Address - Street 1:450 OCEAN AVE
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07305-3274
Practice Address - Country:US
Practice Address - Phone:201-547-3550
Practice Address - Fax:201-547-8355
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-04
Last Update Date:2015-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00436100363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJP00523500OtherCDS REGISTRATION NUMBER
NJ2012020093OtherACNP-BC
NJ26NJ00436100OtherAPN CERTIFICATE