Provider Demographics
NPI:1831296482
Name:NEWMAN, SETH ANDREW (DDS)
Entity Type:Individual
Prefix:DR
First Name:SETH
Middle Name:ANDREW
Last Name:NEWMAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 GLEN COVE RD
Mailing Address - Street 2:STE 100
Mailing Address - City:ROSLYN HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11577-1732
Mailing Address - Country:US
Mailing Address - Phone:516-626-2060
Mailing Address - Fax:
Practice Address - Street 1:14 GLEN COVE RD
Practice Address - Street 2:STE 100
Practice Address - City:ROSLYN HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11577-1732
Practice Address - Country:US
Practice Address - Phone:516-626-2060
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-17
Last Update Date:2012-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY051005-11223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02842111Medicaid