Basic Information
| Provider Information | |||||||||
| NPI: | 1508173337 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | NEWMAN | ||||||||
| FirstName: | JOHN | ||||||||
| MiddleName: | D | ||||||||
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| Credential: | CRNA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 40 FRONT ST. SUITE C | ||||||||
| Address2: | RIVERSIDE ASSOCIATES IN ANESTHESIA | ||||||||
| City: | BINGHAMTON | ||||||||
| State: | NY | ||||||||
| PostalCode: | 13905 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6077227264 | ||||||||
| FaxNumber: | 6077227869 | ||||||||
| Practice Location | |||||||||
| Address1: | 169 RIVERSIDE DR. | ||||||||
| Address2: | OUR LADY OF LOURDES HOSPITAL | ||||||||
| City: | BINGHAMTON | ||||||||
| State: | NY | ||||||||
| PostalCode: | 13905 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6077227264 | ||||||||
| FaxNumber: | 6077227869 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/31/2010 | ||||||||
| LastUpdateDate: | 03/02/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | 580000-1 | NY | N | Nursing Service Providers | Registered Nurse | 367500000X | 085429 | NY | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered |
No ID Information.