Provider Demographics
NPI:1649303074
Name:JOSEPH M NEWMARK MD PC
Entity type:Organization
Organization Name:JOSEPH M NEWMARK MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:MARLAINA
Authorized Official - Middle Name:
Authorized Official - Last Name:KISHBAUGH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:607-797-9036
Mailing Address - Street 1:4104 VESTAL ROAD
Mailing Address - Street 2:SUITE 203 VESTAL EXECUTIVE PARK
Mailing Address - City:VESTAL
Mailing Address - State:NY
Mailing Address - Zip Code:13850
Mailing Address - Country:US
Mailing Address - Phone:607-797-9036
Mailing Address - Fax:607-798-0601
Practice Address - Street 1:4104 VESTAL ROAD
Practice Address - Street 2:SUITE 203 VESTAL EXECUTIVE PARK
Practice Address - City:VESTAL
Practice Address - State:NY
Practice Address - Zip Code:13850
Practice Address - Country:US
Practice Address - Phone:607-797-9036
Practice Address - Fax:607-798-0601
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-14
Last Update Date:2011-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY147249207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty