Provider Demographics
NPI:1790785566
Name:NEWMAN, LEONARD J (MD)
Entity Type:Individual
Prefix:
First Name:LEONARD
Middle Name:J
Last Name:NEWMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 BRADHURST AVE
Mailing Address - Street 2:STE 1400
Mailing Address - City:HAWTHORNE
Mailing Address - State:NY
Mailing Address - Zip Code:10532-2140
Mailing Address - Country:US
Mailing Address - Phone:914-367-0000
Mailing Address - Fax:914-367-0001
Practice Address - Street 1:19 BRADHURST AVE
Practice Address - Street 2:STE. 1400
Practice Address - City:HAWTHORNE
Practice Address - State:NY
Practice Address - Zip Code:10532-2140
Practice Address - Country:US
Practice Address - Phone:914-367-0000
Practice Address - Fax:914-367-0001
Is Sole Proprietor?:No
Enumeration Date:2005-07-22
Last Update Date:2013-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1096222080P0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0206XAllopathic & Osteopathic PhysiciansPediatricsPediatric Gastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00194596Medicaid
CT001287996Medicaid
NY953731Medicare PIN
CT001287996Medicaid
NY95373EA202Medicare PIN