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General NPI Number Information
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NPI Number | 1700808938
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Entity Type | Individual
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Provider Name | DAVID LEWIS MD
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Gender | Male
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Dates
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Enumeration Date | 07/24/2006
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Last Update Date | 10/26/2007
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Provider Practice Location Address
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Address Line | 216 ENGLE ST STE 101
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City | ENGLEWOOD
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State | NJ
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Zip | 07631-2428
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Country | US
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Telephone | 201-816-9800
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Fax |
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Provider Business Mailing Address
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Address Line | 216 ENGLE ST STE 101
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City | ENGLEWOOD
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State | NJ
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Zip | 07631-2428
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Country | US
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Telephone | 201-816-9800
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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 | 207YS0123X
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Taxonomy Name | Facial Plastic Surgery Physician
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License Number | A95117
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207YS0123X
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Taxonomy Name | Facial Plastic Surgery Physician
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License Number | 25MA08262900
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License Number State | NJ
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