Provider Demographics
NPI:1386985943
Name:NEUMAN, MARK JOEL (DO)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:JOEL
Last Name:NEUMAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1130 N BROADWAY STE 120
Mailing Address - Street 2:
Mailing Address - City:MASSAPEQUA
Mailing Address - State:NY
Mailing Address - Zip Code:11758-1339
Mailing Address - Country:US
Mailing Address - Phone:516-566-0805
Mailing Address - Fax:
Practice Address - Street 1:1130 N BROADWAY STE 120
Practice Address - Street 2:
Practice Address - City:MASSAPEQUA
Practice Address - State:NY
Practice Address - Zip Code:11758-1339
Practice Address - Country:US
Practice Address - Phone:516-566-0805
Practice Address - Fax:516-566-0875
Is Sole Proprietor?:No
Enumeration Date:2013-03-07
Last Update Date:2024-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY295007207V00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program