Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VE0102X | Reproductive Endocrinologist | 137023 | NY |
NPI | 1194755967 |
---|---|
Provider Name | Vivian Lewis |
First Address | Rochester, NY 14642-0001 |
Second Address | Rochester, NY 14642-0002 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/07/2006 |
Last Update Date | 26/08/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01222095 | (05) | NY |
1906 | BLUE SHIELD OF ROCHESTER (01) | NY |
4262575 | AETNA (01) | NY |
D13630 | (02) | NY |
MD410M | PREFERRED CARE (01) | NY |
P010137023 | BLUE CHOICE (01) | NY |