Individual
MARY ELLEN LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
801 BOARDWALK, ATLANTIC CITY, NJ 08401-7509
(609) 343-4003
(609) 343-4006
Mailing address
700 PENNLYN PL, OCEAN CITY, NJ 08226-4156
(609) 814-0339
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
25MP00032700
NJ
Other
Enumeration date
07/03/2007
Last updated
07/08/2007
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