Individual
MRS. CHERYL DISCH LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S.R.D.L.D.N.
Contact information
Practice address
1130 HIGHWAY 315 STE B, WILKES BARRE, PA 18702-6952
(570) 823-8896
Mailing address
63 E VAUGHN ST, KINGSTON, PA 18704-4817
(570) 283-1182
Taxonomy
Speciality
Code
Description
License number
State
133VN1005X
Renal Nutrition Registered Dietitian
Primary
DN001033
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
056154
MEDICARE PROVIDER #
PA
01
—
710093
REGISTERED DIETITIAN
PA
01
—
DN001033
LDN LICENSE
PA
Enumeration date
12/04/2006
Last updated
07/08/2007
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