Provider Demographics
NPI:1457432650
Name:LEWIN, ROSALIE
Entity Type:Individual
Prefix:
First Name:ROSALIE
Middle Name:
Last Name:LEWIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LEWIN
Other - Middle Name:THERAPY
Other - Last Name:CENTER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:4891 INDEPENDENCE STREET
Mailing Address - Street 2:# 240
Mailing Address - City:WHEAT RIDGE
Mailing Address - State:CO
Mailing Address - Zip Code:80033-6714
Mailing Address - Country:US
Mailing Address - Phone:303-467-0041
Mailing Address - Fax:303-467-0251
Practice Address - Street 1:4891 INDEPENDENCE ST
Practice Address - Street 2:# 240
Practice Address - City:WHEAT RIDGE
Practice Address - State:CO
Practice Address - Zip Code:80033-6752
Practice Address - Country:US
Practice Address - Phone:303-467-0041
Practice Address - Fax:303-467-0251
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-17
Last Update Date:2009-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAA469940225X00000X
CO9611000457225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
Provider Identifiers
StateIdentifier IDID TypeIssuer
COLE24003OtherBCBS EBILL NUMBER
CO9392081OtherCIGNA PROVIDER NUMBER
CO9392081OtherCIGNA PROVIDER NUMBER
COLE24003OtherBCBS EBILL NUMBER
COC24003Medicare ID - Type UnspecifiedEBILL MEDICARE NUMBER
CO0543850001Medicare NSC