National Provider Identifier

Kimberly J Lewis, MS

Kimberly J Lewis, MS is listed in the NPPES registry with a primary specialty of Specialist in Marion, NY and a listed phone number of (315) 576-0377.

NPI 1740828367Marion, NYSpecialist

Profile Overview

NPI
1740828367
Provider Type
Individual
Primary Specialty
Specialist
Enumeration Date
December 13, 2019
Last Updated
December 13, 2019

Practice Location

  • 3832 Cory Corners RD
  • Marion, NY 14505-9722

Phone: (315) 576-0377

Specialties

  • Specialist (174400000X)
Full Record
NPI
1740828367
Entity Type
Individual
Last Name
Lewis
First Name
Kimberly
Middle Name
J
Credential
MS
Provider Other Last Name
Welch
Provider Other First Name
Kimberly
Provider Other Middle Name
J.
Provider Other Credential Text
MS
Provider Other Last Name Type Code
1
Mailing Street Address
3832 Cory Corners RD
Mailing City
Marion
Mailing State
NY
Mailing ZIP Code
14505-9722
Mailing Country
US
Mailing Phone
(315) 576-0377
Practice Street Address
3832 Cory Corners RD
Practice City
Marion
Practice State
NY
Practice ZIP Code
14505-9722
Practice Country
US
Practice Phone
(315) 576-0377
Enumeration Date
December 13, 2019
Last Updated
December 13, 2019
Sex
Female
Sole Proprietor
Yes
Taxonomy Group 1
193400000X Single Specialty Group
Certification Date
December 13, 2019
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Specialist (174400000X)