Provider Demographics
NPI:1760798599
Name:LEWIS, LUZENEIDA (APN-C)
Entity Type:Individual
Prefix:MRS
First Name:LUZENEIDA
Middle Name:
Last Name:LEWIS
Suffix:
Gender:F
Credentials:APN-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:832 BRUNSWICK AVE
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08638-3847
Mailing Address - Country:US
Mailing Address - Phone:609-815-7400
Mailing Address - Fax:609-815-7401
Practice Address - Street 1:832 BRUNSWICK AVE
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08638-3847
Practice Address - Country:US
Practice Address - Phone:609-815-7400
Practice Address - Fax:609-815-7401
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-31
Last Update Date:2017-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00283200363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily