MEDICARE: JACQUELINE MARGARET LEWIS M.D.,

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	207L00000X	Anesthesiology Physician	195388	NY

General Provider Information

NPI Number	:	1699857888
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JACQUELINE MARGARET LEWIS M.D.,

Provider Business Mailing Address
First Line	:	7 ORCHARD PL
Second Line	:
City	:	NEW ROCHELLE
State	:	NY
Zip	:	10801-3510
Country	:	US
Telephone Number	:	914-576-7337
Fax Number	:	914-576-7337

Provider Business Practice Location Address
First Line	:	7601 4TH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11209-3207
Country	:	US
Telephone Number	:	718-745-0623
Fax Number	:	718-745-8091

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

Provider Enumeration Date	:	10/19/2006
Last Update Date	:	07/08/2007

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