Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LW0102X | Nurse Practitioner - Women's Health | F420159-1 | NY |
NPI | 1073529038 |
---|---|
Provider Name | Nancy Lewis |
First Address | New York, NY 10003-7938 |
Second Address | New York, NY 10013-1510 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/07/2006 |
Last Update Date | 08/07/2007 |