Provider Demographics
NPI:1225655582
Name:LEWIS, MACHELL (HEALTH CARE PROVIDER)
Entity Type:Individual
Prefix:
First Name:MACHELL
Middle Name:
Last Name:LEWIS
Suffix:
Gender:F
Credentials:HEALTH CARE PROVIDER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1421 DENISE ST
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15210-3530
Mailing Address - Country:US
Mailing Address - Phone:412-553-9840
Mailing Address - Fax:
Practice Address - Street 1:1421 DENISE ST
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15210-3530
Practice Address - Country:US
Practice Address - Phone:412-553-9840
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-02
Last Update Date:2020-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA48873601251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health