Individual
JEANNINE MARIE LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPA-C
Contact information
Practice address
5141 BROADWAY, 3FW, NEW YORK, NY 10034-1159
(212) 932-4738
(212) 932-4154
Mailing address
3882 BERGER AVE, BETHPAGE, NY 11714-5002
(516) 317-7886
(212) 932-4154
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
010735
NY
Other
Enumeration date
02/11/2007
Last updated
07/08/2007
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