Individual
MR. LEWIS BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
111 S 11TH ST, PHILA, PA 19107-4824
(215) 955-0715
Mailing address
2410 S BROAD ST, 3RD FLR, PHILA, PA 19145-4418
(215) 462-6600
(215) 462-2650
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN270741-L
PA
367H00000X
Anesthesiologist Assistant
RN270741L
PA
Other
Enumeration date
04/24/2006
Last updated
08/05/2022
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