Healthcare Provider Details

I. General information

NPI: 1588521298
Provider Name (Legal Business Name): CYNTHIA LEWIS RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/06/2026
Last Update Date: 01/06/2026
Certification Date: 01/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1069 RINGWOOD AVE STE 210B
HASKELL NJ
07420-1451
US

IV. Provider business mailing address

534 PRINCETON AVE
BRICK NJ
08724-4865
US

V. Phone/Fax

Practice location:
  • Phone: 201-350-7225
  • Fax:
Mailing address:
  • Phone: 732-674-1969
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number26NR15083600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: