Provider Demographics
NPI:1861753907
Name:LEWIN, KIMBERLY R (MS ED)
Entity type:Individual
Prefix:MR
First Name:KIMBERLY
Middle Name:R
Last Name:LEWIN
Suffix:
Gender:F
Credentials:MS ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 193
Mailing Address - Street 2:
Mailing Address - City:NIAGARA FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:14304-0193
Mailing Address - Country:US
Mailing Address - Phone:716-940-2253
Mailing Address - Fax:
Practice Address - Street 1:570 82ND ST
Practice Address - Street 2:
Practice Address - City:NIAGARA FALLS
Practice Address - State:NY
Practice Address - Zip Code:14304-2373
Practice Address - Country:US
Practice Address - Phone:716-940-2253
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-05
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist