Provider Demographics
NPI:1174349070
Name:MEITZ, LEWIS
Entity type:Individual
Prefix:
First Name:LEWIS
Middle Name:
Last Name:MEITZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:HUNTER
Other - Middle Name:
Other - Last Name:MEITZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:64 BENNETT AVE
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON STATION
Mailing Address - State:NY
Mailing Address - Zip Code:11746-2723
Mailing Address - Country:US
Mailing Address - Phone:934-204-9120
Mailing Address - Fax:
Practice Address - Street 1:2100 MIDDLE COUNTRY RD STE 211B
Practice Address - Street 2:
Practice Address - City:CENTEREACH
Practice Address - State:NY
Practice Address - Zip Code:11720-3553
Practice Address - Country:US
Practice Address - Phone:934-204-9120
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-25
Last Update Date:2024-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program