Provider Demographics
NPI:1376820225
Name:LEWANDOWSKI, KAREN C (MA CCC/SLP-L)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:C
Last Name:LEWANDOWSKI
Suffix:
Gender:F
Credentials:MA CCC/SLP-L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8750 ALLEGANY RD.
Mailing Address - Street 2:
Mailing Address - City:CORFU
Mailing Address - State:NY
Mailing Address - Zip Code:14036
Mailing Address - Country:US
Mailing Address - Phone:585-762-8141
Mailing Address - Fax:
Practice Address - Street 1:8750 ALLEGHANY RD
Practice Address - Street 2:
Practice Address - City:CORFU
Practice Address - State:NY
Practice Address - Zip Code:14036-9702
Practice Address - Country:US
Practice Address - Phone:585-762-8141
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-07
Last Update Date:2011-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011244-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0112441Medicaid