Healthcare Provider Details

I. General information

NPI: 1700046075
Provider Name (Legal Business Name): ARIANE LEWIS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/11/2008
Last Update Date: 02/12/2021
Certification Date: 02/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

530 1ST AVE # HCC-5A
NEW YORK NY
10016-6402
US

IV. Provider business mailing address

76 COMMONWEALTH AVE APT 8
BOSTON MA
02116-3030
US

V. Phone/Fax

Practice location:
  • Phone: 914-479-8669
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number250633
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number254529
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code2084A2900X
TaxonomyNeurocritical Care Physician
License Number254529
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: