Provider Demographics
NPI:1417917238
Name:LEWIS, IRWIN H (MD)
Entity Type:Individual
Prefix:
First Name:IRWIN
Middle Name:H
Last Name:LEWIS
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 1:10 BRASS CASTLE RD
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07882-4327
Mailing Address - Country:US
Mailing Address - Phone:908-835-1910
Mailing Address - Fax:908-835-1886
Practice Address - Street 1:207 STRYKERS RD
Practice Address - Street 2:
Practice Address - City:PHILLIPSBURG
Practice Address - State:NJ
Practice Address - Zip Code:08865-5401
Practice Address - Country:US
Practice Address - Phone:908-859-6568
Practice Address - Fax:908-859-6697
Is Sole Proprietor?:No
Enumeration Date:2006-03-24
Last Update Date:2010-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA34574207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2161605Medicaid
NJ110233596OtherRAILROAD MEDICARE
D96602Medicare UPIN
NJ110233596OtherRAILROAD MEDICARE
NJ183692Medicare PIN