Basic Information
| Provider Information | |||||||||
| NPI: | 1164899084 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ADORE-LEWIS | ||||||||
| FirstName: | MARLENE | ||||||||
| MiddleName: | L | ||||||||
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| Credential: | PT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7404 EXECUTIVE PL STE 300B | ||||||||
| Address2: | 300B | ||||||||
| City: | LANHAM | ||||||||
| State: | MD | ||||||||
| PostalCode: | 207066215 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 7404 EXECUTIVE PL STE 300B | ||||||||
| Address2: | 300B | ||||||||
| City: | LANHAM | ||||||||
| State: | MD | ||||||||
| PostalCode: | 207066215 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3015999500 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/26/2015 | ||||||||
| LastUpdateDate: | 08/26/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363AM0700X | 18044 | MD | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Medical |
No ID Information.