Healthcare Provider Details

I. General information

NPI: 1306842380
Provider Name (Legal Business Name): LEWIS STEIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2005
Last Update Date: 01/24/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5000 AVENUE K
BROOKLYN NY
11234-2202
US

IV. Provider business mailing address

15 MURIEL AVE
LAWRENCE NY
11559-1810
US

V. Phone/Fax

Practice location:
  • Phone: 718-968-1515
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number179380-1
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number1798801
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: