Provider Demographics
NPI:1841557949
Name:PORTNOY, LEWIS MORTON (MD)
Entity type:Individual
Prefix:DR
First Name:LEWIS
Middle Name:MORTON
Last Name:PORTNOY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:10 LINDA LN
Mailing Address - Street 2:
Mailing Address - City:WESTPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06880-3945
Mailing Address - Country:US
Mailing Address - Phone:203-227-3262
Mailing Address - Fax:203-226-2853
Practice Address - Street 1:10 LINDA LN
Practice Address - Street 2:
Practice Address - City:WESTPORT
Practice Address - State:CT
Practice Address - Zip Code:06880-3945
Practice Address - Country:US
Practice Address - Phone:203-222-7326
Practice Address - Fax:203-226-2853
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-13
Last Update Date:2012-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT12993207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology