Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0402X | Child Neurologist | IP1555 | KY |
NPI | 1215461702 |
---|---|
Provider Name | Rodolfo Andres Lewy |
First Address | Lexington, KY 40536-0293 |
Second Address | Lexington, KY 40536 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/04/2017 |
Last Update Date | 04/07/2018 |