Individual
KENNETH ROBERT LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NYCPS-3799
Contact information
Practice address
320 N GOODMAN ST STE 202320, ROCHESTER, NY 14607-1185
(585) 325-3145
(585) 244-3999
Mailing address
320 N GOODMAN ST, ROCHESTER, NY 14607-1185
(585) 325-3145
(585) 244-3999
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
NYCPS-P-3799
NY
Other
Enumeration date
08/18/2020
Last updated
08/18/2020
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