Individual
MISS MARY BETH HOPPE LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
1150 YOUNGS RD, 107, WILLIAMSVILLE, NY 14221-8053
(716) 636-9112
(716) 639-0875
Mailing address
51 BUFFALO CREEK ROAD, ELMA, NY 14059
(716) 805-0069
(716) 639-0875
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
F420496-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000560469002
COMMUNITY BLUE/BLUE CROSS
NY
05
—
01993728
—
NY
01
—
040426000612
FIDELIUS
NY
01
—
050819000018
FIDELIS CARE
NY
01
—
9512294
INDEPENDENT HEALTH
NY
Enumeration date
06/16/2006
Last updated
10/06/2014
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