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General NPI Number Information
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NPI Number | 1154333979
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Entity Type | Organization
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Legal Business Name | MICHAEL P LEWKO MD LLC
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Dates
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Enumeration Date | 08/12/2006
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Last Update Date | 04/25/2008
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Provider Practice Location Address
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Address Line | 871 ALLWOOD RD
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City | CLIFTON
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State | NJ
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Zip | 07012-1922
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Country | US
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Telephone | 973-405-5163
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Fax | 973-365-8004
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Provider Business Mailing Address
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Address Line | 871 ALLWOOD RD
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City | CLIFTON
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State | NJ
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Zip | 07012-1922
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Country | US
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Telephone | 973-405-5163
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Fax | 973-365-8004
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Authorized Official
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Title or Position | OWNER
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Name | DR. MICHAEL P LEWKO
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Credential | MD
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Telephone | 973-405-5163
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number | MA 50349
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License Number State | NJ
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