Healthcare Provider Details

I. General information

NPI: 1306010806
Provider Name (Legal Business Name): BRETT ERIC LEWIS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/15/2008
Last Update Date: 08/30/2026
Certification Date: 08/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 GRAMPIAN BLVD
WILLIAMSPORT PA
17701-1907
US

IV. Provider business mailing address

149 RIDGEDALE AVE
MADISON NJ
07940-1221
US

V. Phone/Fax

Practice location:
  • Phone: 570-326-8203
  • Fax:
Mailing address:
  • Phone: 917-733-6255
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number25MA08312200
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number2010-00507
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: