Individual
COLLEEN LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S.
Contact information
Practice address
91 MALONE AVE, STATEN ISLAND, NY 10306-4109
(718) 570-2097
Mailing address
91 MALONE AVE, STATEN ISLAND, NY 10306-4109
(718) 570-2097
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
883345
NY
Other
Enumeration date
10/03/2013
Last updated
10/03/2013
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