1851477129 NPI number — JEFFREY B NEWTON MD

Table of content: JEFFREY B NEWTON MD (NPI 1851477129)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1851477129 NPI number — JEFFREY B NEWTON MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
NEWTON
Provider First Name:
JEFFREY
Provider Middle Name:
B
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1851477129
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/09/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
77 HERRICK ST
Provider Second Line Business Mailing Address:
SUITE203
Provider Business Mailing Address City Name:
BEVERLY
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01915-2734
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
978-998-4601
Provider Business Mailing Address Fax Number:
978-998-4973

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
77 HERRICK ST
Provider Second Line Business Practice Location Address:
SUITE 203
Provider Business Practice Location Address City Name:
BEVERLY
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01915-2734
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
978-998-4601
Provider Business Practice Location Address Fax Number:
978-998-4973
Provider Enumeration Date:
10/31/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207RP1001X , with the licence number:  34265 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 034265 . This is a "TUFTS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 40858 . This is a "FALLON" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2054663 . This is a "MASS HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: B73750 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: D14263 . This is a "BCBS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2054663 , issued by the state of ( ME ) . This identifiers is of the category "MEDICAID".
  • Identifier: 23568 . This is a "HARVARD PILGRIM" identifier . This identifiers is of the category "OTHER".




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