Individual
DONNELL LEWIS STEWART
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
184 ELDRIDGE ST, NEW YORK, NY 10002
(212) 674-9120
Mailing address
17860 WEXFORD TER, JAMAICA, NY 11432-3051
(646) 334-4937
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
10/01/2019
Last updated
10/01/2019
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