Provider Demographics
NPI:1215244868
Name:NEWMAN, MIRAV MIRIAM (PT)
Entity type:Individual
Prefix:MRS
First Name:MIRAV
Middle Name:MIRIAM
Last Name:NEWMAN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MRS
Other - First Name:MIRAV
Other - Middle Name:
Other - Last Name:NEWMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PT
Mailing Address - Street 1:532 COURT ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11231-3986
Mailing Address - Country:US
Mailing Address - Phone:718-254-0800
Mailing Address - Fax:718-254-0888
Practice Address - Street 1:532 COURT ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11231-3986
Practice Address - Country:US
Practice Address - Phone:718-254-0800
Practice Address - Fax:718-254-0888
Is Sole Proprietor?:No
Enumeration Date:2010-09-02
Last Update Date:2010-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY01615712081P0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPediatric Rehabilitation Medicine