Individual
TANICKA LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
X
Contact information
Practice address
220 5TH AVENUE 4TH FLOOR, SUITE 11, NEW YORK, NY 10001
(212) 564-0480
Mailing address
18 E CAMDEN ST UNIT 543, HACKENSACK, NJ 07601-7557
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
406439
NY
Other
Enumeration date
10/10/2025
Last updated
10/10/2025
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