Basic Information
| Provider Information | |||||||||
| NPI: | 1912960584 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | NEWCOMB | ||||||||
| FirstName: | JOHN | ||||||||
| MiddleName: | P | ||||||||
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| Credential: | CRNA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5 MORNING RD | ||||||||
| Address2: | |||||||||
| City: | RICHMOND | ||||||||
| State: | RI | ||||||||
| PostalCode: | 028921087 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4014919243 | ||||||||
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| Practice Location | |||||||||
| Address1: | WASHINGTON ST | ||||||||
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| City: | NORWICH | ||||||||
| State: | CT | ||||||||
| PostalCode: | 06360 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8608236395 | ||||||||
| FaxNumber: | 8608236563 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/06/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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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 | 367500000X | 003217 | CT | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered |
No ID Information.