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General NPI Number Information
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NPI Number | 1700934254
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Entity Type | Individual
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Provider Name | ANDREA S. GREEN-LEWIS LCSW-R
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Gender | Female
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Dates
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Enumeration Date | 01/08/2007
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Last Update Date | 10/18/2016
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Provider Practice Location Address
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Address Line | 201 E 69TH ST APT. 5T
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City | NEW YORK
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State | NY
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Zip | 10021-5471
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Country | US
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Telephone | 631-525-3475
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Fax |
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Provider Business Mailing Address
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Address Line | 1841 BROADWAY SUITE 400
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City | NEW YORK
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State | NY
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Zip | 10023-7603
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Country | US
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Telephone | 631-525-3475
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 072593
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License Number State |
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