MEDICARE: STEPHANIE 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	251B00000X	Case Management Agency		NJ

General Provider Information

NPI Number	:	1508652751
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHANIE LEWIS

Provider Business Mailing Address
First Line	:	136 2ND AVE APT 3
Second Line	:
City	:	NEWARK
State	:	NJ
Zip	:	07104-5506
Country	:	US
Telephone Number	:	201-471-5145
Fax Number	:

Provider Business Practice Location Address
First Line	:	136 2ND AVE APT 3
Second Line	:
City	:	NEWARK
State	:	NJ
Zip	:	07104-5506
Country	:	US
Telephone Number	:	201-539-5496
Fax Number	:	201-539-5496

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

Provider Enumeration Date	:	04/15/2025
Last Update Date	:	01/22/2026

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Directions to “ STEPHANIE LEWIS ” Practice Location

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