Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213EP1101X | Primary Podiatric Medicine | N003416 | NY |
Y | 213EP1101X | Primary Podiatric Medicine | PO0001952 | FL |
NPI | 1407970908 |
---|---|
Provider Name | Stuart Lewkowitz |
First Address | North Miami Beach, FL 33179 |
Second Address | North Miami Beach, FL 33179-3339 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/03/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
732605 | (05) | NY |
T51087 | (02) |