Healthcare Provider Details

I. General information

NPI: 1447161153
Provider Name (Legal Business Name): PAIGE CAROLINE LEWIS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

116 CLOVER LN
EAST STROUDSBURG PA
18301-7319
US

IV. Provider business mailing address

3063 MILE LANE RD
SAYRE PA
18840-9467
US

V. Phone/Fax

Practice location:
  • Phone: 607-738-6078
  • Fax:
Mailing address:
  • Phone: 607-738-6078
  • Fax:

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 StatePA
# 2
Primary TaxonomyN
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: