Provider Demographics
NPI:1275017378
Name:NEWMAN, GABRIEL JOSEPH
Entity type:Individual
Prefix:
First Name:GABRIEL
Middle Name:JOSEPH
Last Name:NEWMAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1660 FORT ST
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:MI
Mailing Address - Zip Code:48183-2003
Mailing Address - Country:US
Mailing Address - Phone:734-304-4159
Mailing Address - Fax:
Practice Address - Street 1:1660 FORT ST
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:MI
Practice Address - Zip Code:48183-2003
Practice Address - Country:US
Practice Address - Phone:586-204-5560
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-24
Last Update Date:2024-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No156F00000XEye and Vision Services ProvidersTechnician/Technologist