Organization
MARK B. LEW, MD, LLC
Active
Other names
Mark B. Lew, MD, LLC Pediatric Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK B. LEW MD (OWNER)
(718) 859-6440
Entity
Organization
Contact information
Practice address
2704 GLENWOOD RD, BROOKLYN, NY 11210-2326
(718) 859-6440
(718) 434-0368
Mailing address
2704 GLENWOOD RD, BROOKLYN, NY 11210-2326
(718) 859-6440
(718) 434-0368
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
133922
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00512203
—
NY
Enumeration date
01/20/2007
Last updated
08/22/2020
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