Provider Demographics
NPI:1528047297
Name:LEWIS, RACHEL (MD)
Entity type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:
Last Name:LEWIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 W 86TH ST
Mailing Address - Street 2:COLUMBIA.WEST SIDE PEDIATRICS
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-3616
Mailing Address - Country:US
Mailing Address - Phone:212-799-2737
Mailing Address - Fax:212-799-8150
Practice Address - Street 1:21 W 86TH ST
Practice Address - Street 2:COLUMBIA.WEST SIDE PEDIATRICS
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-3616
Practice Address - Country:US
Practice Address - Phone:212-799-2737
Practice Address - Fax:212-799-8150
Is Sole Proprietor?:No
Enumeration Date:2006-01-11
Last Update Date:2022-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY218601208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02319964Medicaid
NY02319964Medicaid