Nicole Lewis
Individual provider Active NPI Registered Nurse · Valatie, NY
NPI 1760065205 · NPPES record last updated May 3, 2021
Key facts
- NPI
- 1760065205
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Nurse 163W00000X
- License
- 664157 (NY)
- Practice address
- 3230 Church St
Valatie, NY 12184-2303 - Phone
- (518) 758-6222
- NPI assigned
- May 3, 2021
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 664157 | NY | MD | Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 664157 | NY | Yes |
Addresses
Primary practice location
3230 Church St
Valatie, NY 12184-2303
Mailing address
3230 Church St
Valatie, NY 12184-2303
Phone (518) 758-6222
Other providers in Valatie, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 3, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.