Basic Information
| Provider Information | |||||||||
| NPI: | 1245278019 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LEWIN | ||||||||
| FirstName: | JONATHAN | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1414 NEWKIRK AVE | ||||||||
| Address2: | |||||||||
| City: | BROOKLYN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 112266522 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7187596100 | ||||||||
| FaxNumber: | 7187596100 | ||||||||
| Practice Location | |||||||||
| Address1: | 1414 NEWKIRK AVE | ||||||||
| Address2: | |||||||||
| City: | BROOKLYN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 112266522 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7187596100 | ||||||||
| FaxNumber: | 7187596100 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/03/2006 | ||||||||
| LastUpdateDate: | 09/29/2008 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | 202693 | NY | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
No ID Information.