Provider Demographics
NPI:1598708745
Name:LEWIS, STEPHEN B (MD)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:B
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 1:1 BIG BARN RD
Mailing Address - Street 2:
Mailing Address - City:CRANBURY
Mailing Address - State:NJ
Mailing Address - Zip Code:08512-3303
Mailing Address - Country:US
Mailing Address - Phone:856-456-0023
Mailing Address - Fax:
Practice Address - Street 1:1 BIG BARN RD
Practice Address - Street 2:
Practice Address - City:CRANBURY
Practice Address - State:NJ
Practice Address - Zip Code:08512-3303
Practice Address - Country:US
Practice Address - Phone:856-456-0023
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2022-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA06345900202D00000X
PA25MA06345900208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No202D00000XAllopathic & Osteopathic PhysiciansIntegrative Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
1037383OtherAETNA
463820OtherPA BLUESHIELD
NJ8402906Medicaid
0149500000OtherAMERIHEALTH
91000682300OtherAMERICHOICE
P1110868OtherOXFORD HEALTH PLAN
1037383OtherAETNA
NJ8402906Medicaid