Provider Demographics
NPI:1063593945
Name:NEWMAN, PATRICIA MAY (PHD)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:MAY
Last Name:NEWMAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 S 68TH AVENUE
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68132-3314
Mailing Address - Country:US
Mailing Address - Phone:402-505-3938
Mailing Address - Fax:877-358-5513
Practice Address - Street 1:330 S 68TH AVENUE
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68132-3314
Practice Address - Country:US
Practice Address - Phone:402-505-3938
Practice Address - Fax:877-358-5513
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE282103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
40104OtherNATIONAL REGISTER
NE100252292000Medicaid
NE282OtherLICENSE
097079Medicare ID - Type Unspecified