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Organization
ST KILDA MEDICAL SERVICE,PLLC
Active
Organization
ST KILDA MEDICAL SERVICE,PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BLAIR S LEWIS MD (OWNER)
(212) 874-3384
Entity
Organization
Contact information
Practice address
1067 5TH AVE, NEW YORK, NY 10128-0101
(212) 874-3384
(212) 874-0031
Mailing address
1067 5TH AVE, NEW YORK, NY 10128-0101
(212) 874-3384
(212) 874-0031
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
156442
NY
Other
Enumeration date
10/07/2010
Last updated
07/21/2011
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