Provider Demographics
NPI:1790845527
Name:NEWIRTH, JOSEPH WILLIAM (PHD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:WILLIAM
Last Name:NEWIRTH
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 CANTERBURY RD
Mailing Address - Street 2:
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11021-2122
Mailing Address - Country:US
Mailing Address - Phone:516-504-0126
Mailing Address - Fax:
Practice Address - Street 1:20 CANTERBURY RD
Practice Address - Street 2:
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11021-2122
Practice Address - Country:US
Practice Address - Phone:516-504-0126
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY3889103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYV18721Medicare ID - Type UnspecifiedMANHATTAN PATIENTS
NYV18722Medicare ID - Type UnspecifiedLONG ISLAND PATIENTS