Provider Demographics
NPI:1144576489
Name:LEW, REBECCA LAM (MSN, FNP-BC)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:LAM
Last Name:LEW
Suffix:
Gender:F
Credentials:MSN, FNP-BC
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:
Other - Last Name:LAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2325 HERITAGE CENTER DR STE 116
Mailing Address - Street 2:
Mailing Address - City:FURLONG
Mailing Address - State:PA
Mailing Address - Zip Code:18925-1262
Mailing Address - Country:US
Mailing Address - Phone:215-794-2462
Mailing Address - Fax:
Practice Address - Street 1:2325 HERITAGE CENTER DR STE 116
Practice Address - Street 2:
Practice Address - City:FURLONG
Practice Address - State:PA
Practice Address - Zip Code:18925
Practice Address - Country:US
Practice Address - Phone:215-794-2462
Practice Address - Fax:215-794-8496
Is Sole Proprietor?:No
Enumeration Date:2012-07-24
Last Update Date:2018-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP018863363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily