Healthcare Provider Details

I. General information

NPI: 1538100557
Provider Name (Legal Business Name): MICHAEL LEWIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2006
Last Update Date: 10/06/2021
Certification Date: 10/06/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

70 NEW CANAAN AVE STE 2NW
NORWALK CT
06850-2600
US

IV. Provider business mailing address

70 NEW CANAAN AVE STE 2NW
NORWALK CT
06850-2600
US

V. Phone/Fax

Practice location:
  • Phone: 203-229-1212
  • Fax: 203-229-1214
Mailing address:
  • Phone: 203-229-1212
  • Fax: 203-229-1214

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number130048
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: