Maxine Andrea Lewis, REGISTERED NURSE

Individual provider Active NPI Registered Nurse · Massapequa PK, NY

NPI 1780915280 · NPPES record last updated Jan 22, 2010

Key facts

NPI
1780915280
Entity type
Individual (NPI type 1)
Primary specialty
Registered Nurse 163W00000X
License
404470 (NY)
Practice address
38 Town House Dr
Massapequa PK, NY 11762-1162
Phone
(516) 244-1683
Fax
(516) 308-4131
NPI assigned
Jan 22, 2010
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

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 404470 NY Yes

Addresses

Primary practice location

38 Town House Dr
Massapequa PK, NY 11762-1162

Mailing address

38 Town House Dr
Massapequa PK, NY 11762-1162
Phone (516) 244-1683

Other providers in Massapequa PK, NY

All providers in Massapequa PK, NY · Registered Nurse in New York

Sources for this page

Verify at the official NPI Registry.