Healthcare Provider Details

I. General information

NPI: 1982725115
Provider Name (Legal Business Name): LUCY V LEWIS NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2007
Last Update Date: 08/01/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2265 3RD AVE
NEW YORK NY
10035-2231
US

IV. Provider business mailing address

2265 3RD AVE
NEW YORK NY
10035-2231
US

V. Phone/Fax

Practice location:
  • Phone: 212-289-6650
  • Fax: 212-360-5088
Mailing address:
  • Phone: 212-289-6650
  • Fax: 212-360-5088

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License Number360017
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: