=====================================================
General NPI Number Information
=====================================================
NPI Number | 1134202831
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | LAI PING LEW-ZEISEL MD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/24/2006
-----------------------------------------------------
Last Update Date | 08/27/2009
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 246 CLIFTON AVE
-----------------------------------------------------
City | CLIFTON
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07011-1900
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 973-478-9299
-----------------------------------------------------
Fax | 973-478-9652
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 246 CLIFTON AVE
-----------------------------------------------------
City | CLIFTON
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07011-1900
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 973-478-9299
-----------------------------------------------------
Fax | 973-478-9652
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208000000X
-----------------------------------------------------
Taxonomy Name | Pediatrics Physician
-----------------------------------------------------
License Number | 215664
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 208000000X
-----------------------------------------------------
Taxonomy Name | Pediatrics Physician
-----------------------------------------------------
License Number | 25MA08243500
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------