Provider Demographics
NPI:1790665453
Name:LEWIS, ISAIAH ELLIS
Entity type:Individual
Prefix:
First Name:ISAIAH
Middle Name:ELLIS
Last Name:LEWIS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2101 WISCONSIN AVE NW APT 438
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20007-2409
Mailing Address - Country:US
Mailing Address - Phone:646-539-8366
Mailing Address - Fax:
Practice Address - Street 1:1427 MARION BARRY AVE SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20020-5614
Practice Address - Country:US
Practice Address - Phone:202-836-4841
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-04
Last Update Date:2025-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator