Individual
TRACI MARIE LEW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DA
Contact information
Practice address
176 GRAND ST, NEW YORK, NY 10013-3786
(973) 919-6160
Mailing address
10 TREMONT TER, LIVINGSTON, NJ 07039-3208
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
—
NJ
Other
Enumeration date
05/20/2021
Last updated
08/14/2024
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