Provider Demographics
NPI:1134217391
Name:SANK, LEWIS I (MD)
Entity type:Individual
Prefix:DR
First Name:LEWIS
Middle Name:I
Last Name:SANK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 NORWOOD AVE APT 9
Mailing Address - Street 2:
Mailing Address - City:SUMMIT
Mailing Address - State:NJ
Mailing Address - Zip Code:07901-1936
Mailing Address - Country:US
Mailing Address - Phone:908-277-0066
Mailing Address - Fax:908-573-3033
Practice Address - Street 1:33 OVERLOOK RD
Practice Address - Street 2:403
Practice Address - City:SUMMIT
Practice Address - State:NJ
Practice Address - Zip Code:07901-3570
Practice Address - Country:US
Practice Address - Phone:908-277-0050
Practice Address - Fax:908-277-0201
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2007-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA19425NJ174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist