1568660868 NPI number — SARI A. LEWIS SARI LEWIS

Table of content: SARI A. LEWIS SARI LEWIS (NPI 1568660868)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1568660868 NPI number — SARI A. LEWIS SARI LEWIS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LEWIS
Provider First Name:
SARI
Provider Middle Name:
A.
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
SARI LEWIS
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
LEFCO
Provider Other First Name:
SARI
Provider Other Middle Name:
ANN
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
SARI LEWIS, OTRL
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1568660868
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/04/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
14700 N FRANK LLOYD WRIGHT BLVD
Provider Second Line Business Mailing Address:
#157 PMB 350
Provider Business Mailing Address City Name:
SCOTTSDALE
Provider Business Mailing Address State Name:
AZ
Provider Business Mailing Address Postal Code:
85260-2046
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
480-998-8448
Provider Business Mailing Address Fax Number:
480-451-1352

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10601 N HAYDEN RD
Provider Second Line Business Practice Location Address:
SUITE I-108
Provider Business Practice Location Address City Name:
SCOTTSDALE
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85260-5570
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
480-998-8448
Provider Business Practice Location Address Fax Number:
480-451-1352
Provider Enumeration Date:
07/07/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225X00000X , with the licence number:  0834 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0834 . This is a "AZ OT LICENSE" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".




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