MEDICARE: LEW MEDICAL PC

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	174400000X	Specialist	195550	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	G44209	OTHER	NY	UPIN

General Provider Information

NPI Number	:	1811177066
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LEW MEDICAL PC

Provider Business Mailing Address
First Line	:	21902 LINDEN BLVD
Second Line	:
City	:	CAMBRIA HEIGHTS
State	:	NY
Zip	:	11411-1619
Country	:	US
Telephone Number	:	718-978-5938
Fax Number	:	718-978-1342

Provider Business Practice Location Address
First Line	:	21902 LINDEN BLVD
Second Line	:
City	:	CAMBRIA HEIGHTS
State	:	NY
Zip	:	11411-1619
Country	:	US
Telephone Number	:	718-978-5938
Fax Number	:	718-978-1342

Authorized Official
Title or Position	:	MD
Name	:	DR. LORRAINE E. WILLIAMS
Credential	:	MD
Telephone Number	:	718-978-5938

Provider Enumeration Date	:	11/05/2007
Last Update Date	:	11/05/2007

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Directions to “LEW MEDICAL PC ” Practice Location

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