Provider Demographics
NPI:1083929517
Name:BERNARD D LEWIN M.D.,P.C.
Entity Type:Organization
Organization Name:BERNARD D LEWIN M.D.,P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BERNARD
Authorized Official - Middle Name:D
Authorized Official - Last Name:LEWIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-740-5440
Mailing Address - Street 1:8791 193RD ST
Mailing Address - Street 2:
Mailing Address - City:HOLLIS
Mailing Address - State:NY
Mailing Address - Zip Code:11423-1440
Mailing Address - Country:US
Mailing Address - Phone:718-740-5440
Mailing Address - Fax:718-740-5447
Practice Address - Street 1:8791 193RD ST
Practice Address - Street 2:
Practice Address - City:HOLLIS
Practice Address - State:NY
Practice Address - Zip Code:11423-1440
Practice Address - Country:US
Practice Address - Phone:718-740-5440
Practice Address - Fax:718-740-5447
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-09
Last Update Date:2010-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY125160207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty