Individual
COREY DWAYNE LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
191 JORALEMON ST, BROOKLYN, NY 11201-4353
(718) 722-6193
(718) 722-6189
Mailing address
21720 136TH AVE, SPRINGFIELD GARDENS, NY 11413-2245
(212) 920-5813
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
NYCPS-P-22201
NY
175T00000X
Peer Specialist
—
—
Other
Enumeration date
05/21/2025
Last updated
05/29/2025
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