Individual
SHYQUAL M LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
120 HOBART ST, UTICA, NY 13501-4308
(315) 798-1149
(315) 734-3565
Mailing address
2209 GENESEE ST, BUSINESS OFFICE ROOM 315, UTICA, NY 13501
(315) 801-3282
(315) 801-8391
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
339188
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/12/2022
Last updated
08/27/2025
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