Provider Demographics
NPI:1578645032
Name:NEWMAN, HELEN MIA (OTR)
Entity Type:Individual
Prefix:
First Name:HELEN MIA
Middle Name:
Last Name:NEWMAN
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 593
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON MANOR
Mailing Address - State:NY
Mailing Address - Zip Code:12758-0593
Mailing Address - Country:US
Mailing Address - Phone:845-439-3567
Mailing Address - Fax:
Practice Address - Street 1:14 HARRIS BUSHVILLE RD
Practice Address - Street 2:
Practice Address - City:HARRIS
Practice Address - State:NY
Practice Address - Zip Code:12742
Practice Address - Country:US
Practice Address - Phone:845-794-0209
Practice Address - Fax:845-794-0716
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-20
Last Update Date:2019-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002310-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY002310-1Medicaid
NY002310-1OtherLICENSE