Basic Information
| Provider Information | |||||||||
| NPI: | 1689274599 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WYMAN-LEWIS | ||||||||
| FirstName: | DONNA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 23 HULIN ST | ||||||||
| Address2: | |||||||||
| City: | MECHANICVILLE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 121181104 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 600 FRANKLIN ST STE 204 | ||||||||
| Address2: | |||||||||
| City: | SCHENECTADY | ||||||||
| State: | NY | ||||||||
| PostalCode: | 123052100 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5183727031 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/29/2020 | ||||||||
| LastUpdateDate: | 12/10/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 12/10/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | 495926 | NY | Y | Nursing Service Providers | Registered Nurse |
No ID Information.