Provider Demographics
NPI:1396317947
Name:HALEY A. NEWSTROM, O.D., P.A.
Entity type:Organization
Organization Name:HALEY A. NEWSTROM, O.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:HALEY
Authorized Official - Middle Name:
Authorized Official - Last Name:NEWSTROM
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:954-235-8870
Mailing Address - Street 1:60 NW 35TH ST
Mailing Address - Street 2:
Mailing Address - City:OAKLAND PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33309-5202
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:650 N CONGRESS AVE
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33426-3445
Practice Address - Country:US
Practice Address - Phone:561-752-9779
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-13
Last Update Date:2021-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty