MEDICARE: EVAN GREGORY LEWIS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	170300000X	Genetic Counselor (M.S.)

General Provider Information

NPI Number	:	1366393480
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EVAN GREGORY LEWIS

Provider Business Mailing Address
First Line	:	333 COTTMAN AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19111-2497
Country	:	US
Telephone Number	:	215-728-2786
Fax Number	:	215-728-4061

Provider Business Practice Location Address
First Line	:	333 COTTMAN AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19111-2497
Country	:	US
Telephone Number	:	215-728-2786
Fax Number	:	215-728-4061

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/05/2026
Last Update Date	:	02/05/2026

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Directions to “ EVAN GREGORY LEWIS ” Practice Location

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