Provider Demographics
NPI:1528024817
Name:LEWIS, ANDREW (MD)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:
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 1:310 N HIGHLAND AVE
Mailing Address - Street 2:STE 3
Mailing Address - City:OSSINING
Mailing Address - State:NY
Mailing Address - Zip Code:10562-6300
Mailing Address - Country:US
Mailing Address - Phone:914-923-0201
Mailing Address - Fax:914-923-0209
Practice Address - Street 1:310 N HIGHLAND AVE
Practice Address - Street 2:STE 3
Practice Address - City:OSSINING
Practice Address - State:NY
Practice Address - Zip Code:10562-6300
Practice Address - Country:US
Practice Address - Phone:914-923-0201
Practice Address - Fax:914-923-0209
Is Sole Proprietor?:No
Enumeration Date:2006-04-25
Last Update Date:2017-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY169491174400000X, 2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01562147Medicaid
NY8428UPOtherMEDICARE (GHI)
NY01562147Medicaid
F61758Medicare UPIN