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General NPI Number Information
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NPI Number | 1093585895
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Entity Type | Individual
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Provider Name | AMANDA LEWIS NP
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Gender | Female
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Dates
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Enumeration Date | 01/03/2024
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Last Update Date | 04/08/2025
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Provider Practice Location Address
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Address Line | 5 REGENT ST STE 509
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City | LIVINGSTON
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State | NJ
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Zip | 07039-1682
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Country | US
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Telephone | 973-251-2437
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Fax |
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Provider Business Mailing Address
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Address Line | 40 MAIN ST
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City | CHATHAM
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State | NJ
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Zip | 07928-2431
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Country | US
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Telephone | 736-350-8009
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 26NR20235300
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 26NJ14970300
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License Number State | NJ
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 26NJ14970300
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License Number State | NJ
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