Provider Demographics
NPI:1174882757
Name:NEWELL, MARY AGNES (DO)
Entity type:Individual
Prefix:DR
First Name:MARY
Middle Name:AGNES
Last Name:NEWELL
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:MAGGIE
Other - Middle Name:GARVEY
Other - Last Name:NEWELL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DO
Mailing Address - Street 1:183RD ST. AND THIRD AVE.
Mailing Address - Street 2:ST. BARNABAS HOSPITAL EMERGENCY DEPARTMENT
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10457
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:183RD ST. AND THIRD AVE.
Practice Address - Street 2:ST. BARNABAS HOSPITAL EMERGENCY DEPARTMENT
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10457
Practice Address - Country:US
Practice Address - Phone:718-960-9000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-16
Last Update Date:2015-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NY268239-1207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program