Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | MD428470 | PA |
Y | 2080A0000X | Adolescent Medicine | MD428470 | PA |
NPI | 1184825226 |
---|---|
Provider Name | Valerie Joyce Lewis |
First Address | Philadelphia, PA 19178-3311 |
Second Address | Allentown, PA 18104-5052 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/05/2007 |
Last Update Date | 09/03/2016 |