Provider Demographics
NPI:1851994925
Name:LEWIS, DAVID (OTD, OTR/L)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:
Last Name:LEWIS
Suffix:
Gender:M
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:381 COUNTY ROUTE 48
Mailing Address - Street 2:
Mailing Address - City:THOMPSON RIDGE
Mailing Address - State:NY
Mailing Address - Zip Code:10985-2012
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:381 COUNTY ROUTE 48
Practice Address - Street 2:
Practice Address - City:THOMPSON RIDGE
Practice Address - State:NY
Practice Address - Zip Code:10985-2012
Practice Address - Country:US
Practice Address - Phone:845-313-5355
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-19
Last Update Date:2020-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY025251225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist