Provider Demographics
NPI:1518025667
Name:LEWIS, SUZANNE KWOKA (MD)
Entity Type:Individual
Prefix:DR
First Name:SUZANNE
Middle Name:KWOKA
Last Name:LEWIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:180 FORT WASHINGTON AVE
Mailing Address - Street 2:THE HARKNESS PAVILION, SUITE 956
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032-3735
Mailing Address - Country:US
Mailing Address - Phone:212-305-7492
Mailing Address - Fax:212-305-3738
Practice Address - Street 1:180 FORT WASHINGTON AVE
Practice Address - Street 2:THE HARKNESS PAVILION, SUITE 956
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-3735
Practice Address - Country:US
Practice Address - Phone:212-305-7492
Practice Address - Fax:212-305-3738
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY167035207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYE68913Medicare UPIN