Provider Demographics
NPI:1023174232
Name:THOMPKINS-LEWIS, SHAHARAZADE RASIA
Entity type:Individual
Prefix:MRS
First Name:SHAHARAZADE
Middle Name:RASIA
Last Name:THOMPKINS-LEWIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2121 CEDAR AVE
Mailing Address - Street 2:APT. #7C
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10468-5531
Mailing Address - Country:US
Mailing Address - Phone:718-295-1661
Mailing Address - Fax:
Practice Address - Street 1:2250 RYER AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10457-1104
Practice Address - Country:US
Practice Address - Phone:718-960-0609
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator