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NPI Code Detail

MEDICARE: MS. SUSAN ANN LEWIS PA-C

MEDICARE:  MS. SUSAN ANN LEWIS  PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant004778-01NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1659385169
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. SUSAN ANN LEWIS PA-C
Provider Business Mailing Address
First Line : 150 S HUNTINGTON AVE
Second Line :
City : BOSTON
State : MA
Zip : 02130-4893
Country : US
Telephone Number : 617-963-4460
Fax Number :
Provider Business Practice Location Address
First Line : 150 S HUNTINGTON AVE
Second Line :
City : BOSTON
State : MA
Zip : 02130-4893
Country : US
Telephone Number : 617-963-4460
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/28/2006
Last Update Date : 01/21/2026

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Directions to “ MS. SUSAN ANN LEWIS PA-C” Practice Location

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