Basic Information
Provider Information
NPI: 1134216823
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LEWANDOWSKI
FirstName: JUNE
MiddleName: A.
NamePrefix:  
NameSuffix:  
Credential: MA, PT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 520 PHILADELPHIA ST
Address2:  
City: INDIANA
State: PA
PostalCode: 157013902
CountryCode: US
TelephoneNumber: 7244637478
FaxNumber: 7244630931
Practice Location
Address1: 75 S MAIN ST
Address2:  
City: YARDLEY
State: PA
PostalCode: 190671510
CountryCode: US
TelephoneNumber: 2154931889
FaxNumber: 2154932164
Other Information
ProviderEnumerationDate: 10/06/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000XPT005261LPAY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

ID Information
IDTypeStateIssuerDescription
23443301PAHEALTH AMER/HEALTH ASSUR.OTHER
065513400001PAINDEPENDENCE BLUE CROSSOTHER
78230601PAHIGHMARK BLUE SHIELDOTHER


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