Provider Demographics
NPI:1659559284
Name:ALAN NEWMARK, DPM
Entity Type:Organization
Organization Name:ALAN NEWMARK, DPM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PODIATRIST
Authorized Official - Prefix:
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:
Authorized Official - Last Name:NEWMARK
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:718-857-9004
Mailing Address - Street 1:34 PLAZA ST E
Mailing Address - Street 2:SUITE 107
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11238-5038
Mailing Address - Country:US
Mailing Address - Phone:718-857-9004
Mailing Address - Fax:718-857-7251
Practice Address - Street 1:34 PLAZA ST E
Practice Address - Street 2:SUITE 107
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11238-5038
Practice Address - Country:US
Practice Address - Phone:718-857-9004
Practice Address - Fax:718-857-7251
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-06
Last Update Date:2008-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN003108332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY5444490001Medicare NSC