Individual
JASON LEW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
55 FRUIT ST, BOSTON, MA 02114-2621
(617) 952-5000
Mailing address
300 1ST AVE, CHARLESTOWN, MA 02129-3109
(805) 714-7935
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
1019690
MA
2081P0301X
Brain Injury Medicine (Physical Medicine & Rehabilitation) Physician
1019690
MA
Other
Enumeration date
04/09/2019
Last updated
06/24/2024
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