Provider Demographics
NPI:1477876043
Name:LEWIS, SEAN (RN)
Entity type:Individual
Prefix:
First Name:SEAN
Middle Name:
Last Name:LEWIS
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2538 BEDFORD AVE APT 3
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11226-7051
Mailing Address - Country:US
Mailing Address - Phone:347-387-8895
Mailing Address - Fax:
Practice Address - Street 1:2538 BEDFORD AVE APT 3
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11226-7051
Practice Address - Country:US
Practice Address - Phone:347-387-8895
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-10
Last Update Date:2022-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY612845-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse