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General NPI Number Information
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NPI Number | 1669090916
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Entity Type | Individual
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Provider Name | AARON LEWIS OD
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Gender | Male
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Dates
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Enumeration Date | 07/13/2020
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Last Update Date | 07/16/2024
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Provider Practice Location Address
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Address Line | 139 HAZARD AVE STE 1
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City | ENFIELD
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State | CT
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Zip | 06082-4585
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Country | US
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Telephone | 860-749-1233
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Fax | 860-749-4613
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Provider Business Mailing Address
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Address Line | 171 WEST ST
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City | KEENE
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State | NH
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Zip | 03431-3365
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Country | US
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Telephone |
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | CT003186
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License Number State | CT
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