Provider Demographics
NPI:1205807062
Name:AMINLEWIS, ESLA (CNM)
Entity type:Individual
Prefix:MRS
First Name:ESLA
Middle Name:
Last Name:AMINLEWIS
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 STEVENS ST
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:CT
Mailing Address - Zip Code:06850-3852
Mailing Address - Country:US
Mailing Address - Phone:203-852-2353
Mailing Address - Fax:
Practice Address - Street 1:121 WATER ST
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:CT
Practice Address - Zip Code:06854-3013
Practice Address - Country:US
Practice Address - Phone:203-899-1770
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-30
Last Update Date:2024-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000120367A00000X
NY000271367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004184933Medicaid
CT2V4341OtherHEALTHNET
CTP1903078OtherOXFORD
CT000120OtherCONNECTICARE
CT004200458-00OtherANTHEM
CT1080099OtherCIGNA
420000082Medicare ID - Type UnspecifiedMEDICARE