Provider Demographics
NPI:1609383280
Name:NEWMAN, NADINA LEE (LMT)
Entity Type:Individual
Prefix:
First Name:NADINA
Middle Name:LEE
Last Name:NEWMAN
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:246 SUMMIT AVE APT C4
Mailing Address - Street 2:
Mailing Address - City:JENKINTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19046-3141
Mailing Address - Country:US
Mailing Address - Phone:267-625-7939
Mailing Address - Fax:
Practice Address - Street 1:302 COTTMAN ST FL 1
Practice Address - Street 2:
Practice Address - City:JENKINTOWN
Practice Address - State:PA
Practice Address - Zip Code:19046-2821
Practice Address - Country:US
Practice Address - Phone:267-625-7939
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-04
Last Update Date:2018-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMSG003831225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist