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General NPI Number Information
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NPI Number | 1902031073
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Entity Type | Individual
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Provider Name | MICHAEL LOREN LEWIS M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/19/2009
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Last Update Date | 05/08/2023
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Provider Practice Location Address
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Address Line | 506 6 STREET
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City | BROOKLYN
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State | NY
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Zip | 11215
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Country | US
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Telephone | 718-780-3272
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Fax | 718-780-3079
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Provider Business Mailing Address
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Address Line | PO BOX 5453
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City | NEW YORK
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State | NY
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Zip | 10087-5453
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Country | US
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Telephone | 718-780-3272
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Fax | 718-780-3079
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | A107781
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 257204
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License Number State | NY
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