Healthcare Provider Details

I. General information

NPI: 1174487839
Provider Name (Legal Business Name): VICTORIA AMBIKA LEWIS PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/16/2025
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

462 1ST AVE
NEW YORK NY
10016-9196
US

IV. Provider business mailing address

462 1ST AVE
NEW YORK NY
10016-9196
US

V. Phone/Fax

Practice location:
  • Phone: 212-562-4922
  • Fax:
Mailing address:
  • Phone: 212-562-4922
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number027712
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: