Provider Demographics
NPI:1306842380
Name:STEIN, LEWIS (MD)
Entity Type:Individual
Prefix:
First Name:LEWIS
Middle Name:
Last Name:STEIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 MURIEL AVE
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:NY
Mailing Address - Zip Code:11559-1810
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5000 AVENUE K
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11234-2202
Practice Address - Country:US
Practice Address - Phone:718-968-1515
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-06-23
Last Update Date:2015-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY179380-1174400000X
NY1798801207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY040426017738OtherFIDELIS
NY1945T1OtherEMPIRE BCBS
NY1945T2OtherEMPIRE BCBS
NY0133900OtherGHI
NY01196607Medicaid
NY040426017738OtherFIDELIS
NY01196607Medicaid
E48890Medicare UPIN