Provider Demographics
NPI:1063737872
Name:LEWIS, ALEXANDRA (CNIM)
Entity type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:
Last Name:LEWIS
Suffix:
Gender:F
Credentials:CNIM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 INTERLOCKEN BLVD
Mailing Address - Street 2:SUITE 360
Mailing Address - City:BROOMFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:80021-3477
Mailing Address - Country:US
Mailing Address - Phone:720-536-2392
Mailing Address - Fax:303-962-4819
Practice Address - Street 1:4375 W 118TH PL
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80031-5041
Practice Address - Country:US
Practice Address - Phone:202-316-9902
Practice Address - Fax:303-302-1591
Is Sole Proprietor?:No
Enumeration Date:2010-04-05
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnostic