Healthcare Provider Details

I. General information

NPI: 1104855055
Provider Name (Legal Business Name): BERNARD LEWIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/02/2006
Last Update Date: 08/16/2023
Certification Date: 08/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3264 PAPER MILL RD
HUNTINGDON VALLEY PA
19006-3720
US

IV. Provider business mailing address

3264 PAPER MILL RD
HUNTINGDON VALLEY PA
19006-3720
US

V. Phone/Fax

Practice location:
  • Phone: 215-776-0499
  • Fax:
Mailing address:
  • Phone: 215-776-0499
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License NumberMD035816E
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberMD035816E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: