Healthcare Provider Details

I. General information

NPI: 1801125109
Provider Name (Legal Business Name): NADENE CYNTHIA LEWIS R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/15/2009
Last Update Date: 12/06/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1535 ROCKAWAY PKWY RENAISSANCE HOME HEALTH CARE
BROOKLYN NY
11236-4001
US

IV. Provider business mailing address

9506 SCHENCK ST
BROOKLYN NY
11236-5428
US

V. Phone/Fax

Practice location:
  • Phone: 718-649-3670
  • Fax: 718-649-3671
Mailing address:
  • Phone: 718-444-0444
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number522056-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: