Individual
DAVID LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1801 6TH AVE, TROY, NY 12180-3440
(518) 274-5143
(518) 273-1350
Mailing address
PO BOX 417153, BOSTON, MA 02241-7153
(518) 952-8140
(518) 952-8287
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03008266
—
NY
Enumeration date
11/01/2012
Last updated
11/01/2012
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