Provider Demographics
NPI:1992165906
Name:LEWIS, ROBIN
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:
Last Name:LEWIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1372 WASHINGTON AVE
Mailing Address - Street 2:APT 18A
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10456-2005
Mailing Address - Country:US
Mailing Address - Phone:757-462-6491
Mailing Address - Fax:
Practice Address - Street 1:1372 WASHINGTON AVE
Practice Address - Street 2:APT 18A
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10456-2005
Practice Address - Country:US
Practice Address - Phone:757-462-6491
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-03
Last Update Date:2016-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1744P3200XOther Service ProvidersSpecialistProsthetics Case Management