Provider Demographics
NPI:1386875565
Name:HARRIS, LEWIS S (OD)
Entity type:Individual
Prefix:MR
First Name:LEWIS
Middle Name:S
Last Name:HARRIS
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:70 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NEW CITY
Mailing Address - State:NY
Mailing Address - Zip Code:10956-3514
Mailing Address - Country:US
Mailing Address - Phone:845-634-8816
Mailing Address - Fax:845-634-8728
Practice Address - Street 1:70 S MAIN ST
Practice Address - Street 2:
Practice Address - City:NEW CITY
Practice Address - State:NY
Practice Address - Zip Code:10956-3514
Practice Address - Country:US
Practice Address - Phone:845-634-8816
Practice Address - Fax:845-634-8728
Is Sole Proprietor?:No
Enumeration Date:2009-08-05
Last Update Date:2009-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYT002438-1152W00000X, 152WC0802X, 152WX0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
No152WX0102XEye and Vision Services ProvidersOptometristOccupational Vision