Provider Demographics
NPI:1972065498
Name:NEWCOMB, MAKAYLA LYNN (RRT, AE-C)
Entity type:Individual
Prefix:
First Name:MAKAYLA
Middle Name:LYNN
Last Name:NEWCOMB
Suffix:
Gender:F
Credentials:RRT, AE-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 EASY ST
Mailing Address - Street 2:
Mailing Address - City:STERLING
Mailing Address - State:CT
Mailing Address - Zip Code:06377-1531
Mailing Address - Country:US
Mailing Address - Phone:401-212-7673
Mailing Address - Fax:
Practice Address - Street 1:1 HOPPIN ST STE 204
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02903-4141
Practice Address - Country:US
Practice Address - Phone:401-793-8748
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-03
Last Update Date:2019-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIRCP01305227900000X
RI6518174H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator
No227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered