Individual
MARK BERNARD LEW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2704 GLENWOOD RD, MARK B. LEW, MD, LLC, BROOKLYN, NY 11210-2326
(718) 859-6440
(718) 434-0368
Mailing address
2704 GLENWOOD RD, MARK B. LEW, MD, LLC, 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
04/21/2006
Last updated
10/28/2011
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