Healthcare Provider Details

I. General information

NPI: 1316528037
Provider Name (Legal Business Name): CHARISSA PATRICIA LEWIS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/15/2021
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

448 TEMPLE HILL RD
NEW WINDSOR NY
12553-5510
US

IV. Provider business mailing address

448 TEMPLE HILL RD
NEW WINDSOR NY
12553-5510
US

V. Phone/Fax

Practice location:
  • Phone: 845-562-2191
  • Fax: 845-913-7172
Mailing address:
  • Phone: 845-562-2191
  • Fax: 845-913-7172

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: