Provider Demographics
NPI:1548333941
Name:BRIOT, LEWIS S (PA)
Entity type:Individual
Prefix:
First Name:LEWIS
Middle Name:S
Last Name:BRIOT
Suffix:
Gender:M
Credentials:PA
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Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:90 PRESIDENTIAL PLZ
Mailing Address - Street 2:4TH FLOOR
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13202-2240
Mailing Address - Country:US
Mailing Address - Phone:315-464-4243
Mailing Address - Fax:315-464-5350
Practice Address - Street 1:90 PRESIDENTIAL PLZ
Practice Address - Street 2:4TH FLOOR
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13202-2240
Practice Address - Country:US
Practice Address - Phone:315-464-4243
Practice Address - Fax:315-464-5350
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2010-05-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY008351363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02256375Medicaid
NYJ400006883Medicare PIN