Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225X00000X | Occupational Therapist | 019179 | NY |
Y | 225X00000X | Occupational Therapist | 46TR00169400 | NJ |
N | 225XF0002X | Feeding, Eating & Swallowing | 019179 | NY |
N | 225XF0002X | Feeding, Eating & Swallowing | 46TR00169400 | NJ |
N | 225XG0600X | Occupational Therapist - Gerontology | 019179 | NY |
N | 225XN1300X | Occupational Therapist - Neurorehabilitation | 019179 | NY |
N | 225XN1300X | Occupational Therapist - Neurorehabilitation | 46TR00169400 | NJ |
N | 225XP0200X | Occupational Therapist - Pediatrics | 019179 | NY |
N | 225XP0200X | Occupational Therapist - Pediatrics | 46TR00169400 | NJ |
NPI | 1205980117 |
---|---|
Provider Name | Ms. Eileen Mary Lewis |
First Address | Carmel, NY 10512-2005 |
Second Address | Carmel, NY 10512-2005 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/01/2007 |
Last Update Date | 12/03/2015 |