Provider Demographics
NPI:1972356558
Name:LEWIS, GARRETT FRANCIS
Entity Type:Individual
Prefix:
First Name:GARRETT
Middle Name:FRANCIS
Last Name:LEWIS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 BANK ST APT PHB
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10606-2016
Mailing Address - Country:US
Mailing Address - Phone:607-745-8706
Mailing Address - Fax:
Practice Address - Street 1:4622 OLEANDER DR
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-5149
Practice Address - Country:US
Practice Address - Phone:910-375-1413
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-11
Last Update Date:2024-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program