Healthcare Provider Details

I. General information

NPI: 1801852728
Provider Name (Legal Business Name): MARGIE AILEEN GERENA-LEWIS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MARGIE AILEEN GERENA ROSARIO MD

II. Dates (important events)

Enumeration Date: 04/21/2006
Last Update Date: 11/01/2024
Certification Date: 11/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3545 LINCOLN WAY E STE B
MASSILLON OH
44646-8624
US

IV. Provider business mailing address

4600 MONTGOMERY RD STE 400
CINCINNATI OH
45212-2600
US

V. Phone/Fax

Practice location:
  • Phone: 513-834-7063
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number35081831
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code207RA0401X
TaxonomyAddiction Medicine (Internal Medicine) Physician
License Number35.081831
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: