Provider Demographics
NPI:1962489799
Name:NEWMAN, MARTIN P (OD)
Entity Type:Individual
Prefix:DR
First Name:MARTIN
Middle Name:P
Last Name:NEWMAN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 E MANNING ST
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02906-5109
Mailing Address - Country:US
Mailing Address - Phone:401-272-2020
Mailing Address - Fax:401-421-5979
Practice Address - Street 1:150 E MANNING ST
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02906-5109
Practice Address - Country:US
Practice Address - Phone:401-272-2020
Practice Address - Fax:401-421-5979
Is Sole Proprietor?:No
Enumeration Date:2005-12-22
Last Update Date:2012-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIRIOD377152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI603940OtherTUFTS GROUP #
RI799713OtherTUFTS
RI410040027OtherRAILROAD MEDICARE
RI7000876OtherCIGNA
RI003147OtherBLUE CHIP
RI26587OtherRI BLUE SHIELD
RI2813OtherNEIGHBORHOOD RI
RI0859OtherNHP RI GROUP #
RI7000876Medicaid
RIAA3741OtherHARVARD
RI2200288OtherUNITED
RI5097231OtherAETNA
RI26587OtherRI BLUE SHIELD
RI007005641Medicare PIN
RI2200288OtherUNITED