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Individual

MRS. BEVERLY D LEWIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
OTA/L

Contact information

Practice address
1887 BATHGATE AVE, BRONX, NY 10457-6216
(718) 466-3580
Mailing address
140 DEBS PL APT 6A, BRONX, NY 10475-2565
(718) 379-7228

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
006152-1
NY

Other

Enumeration date
09/14/2010
Last updated
09/14/2010
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