Individual
JEREMY LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
56 FRANKLIN ST, WATERBURY, CT 06706-1253
(203) 709-6479
Mailing address
290 BUTTRICK AVE APT G3, BRONX, NY 10465-3290
(347) 653-7416
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
03/31/2022
Last updated
03/31/2022
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