Individual
MR. CHARLES E LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
3322 28TH ST, B, ASTORIA, NY 11106-3475
(516) 857-5192
Mailing address
3322 28TH ST, B, ASTORIA, NY 11106-3475
(516) 857-5192
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
310095
NY
Other
Enumeration date
09/24/2012
Last updated
09/24/2012
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