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NPI 1184180663

NPI 1184180663 : EMILY LEWIS PA : SOUTH KINGSTOWN, RI

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General NPI Number Information
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    NPI Number           |    1184180663
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    Entity Type          |    Individual 
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    Provider Name        |    EMILY LEWIS PA
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    02/20/2019
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    Last Update Date     |    12/17/2025
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Provider Practice Location Address
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    Address Line         |    65 VILLAGE SQUARE DR STE 201 
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    City                 |    SOUTH KINGSTOWN
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    State                |    RI
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    Zip                  |    02879-2569
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    Country              |    US
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    Telephone            |    401-444-7959
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    Fax                  |    401-515-7910
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Provider Business Mailing Address
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    Address Line         |    15 LA SALLE SQ 
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    City                 |    PROVIDENCE
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    State                |    RI
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    Zip                  |    02903-1814
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    Country              |    US
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    Telephone            |    401-443-5112
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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        |    363AM0700X
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    Taxonomy Name        |    Medical Physician Assistant
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    License Number       |    PA01508
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    License Number State |    RI
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