Provider Demographics
NPI:1578750253
Name:LEWIS A. OPLER, M.D., PH.D., P.C.
Entity Type:Organization
Organization Name:LEWIS A. OPLER, M.D., PH.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LEWIS
Authorized Official - Middle Name:A
Authorized Official - Last Name:OPLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:914-629-1605
Mailing Address - Street 1:765 GRAMATAN AVE
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:NY
Mailing Address - Zip Code:10552-1043
Mailing Address - Country:US
Mailing Address - Phone:914-668-4799
Mailing Address - Fax:914-668-4814
Practice Address - Street 1:765 GRAMATAN AVE
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:NY
Practice Address - Zip Code:10552-1043
Practice Address - Country:US
Practice Address - Phone:914-668-4799
Practice Address - Fax:914-668-4814
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-26
Last Update Date:2007-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1327922084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYWAW351Medicare PIN