MEDICARE: DR. ROSS G HEWITT MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RI0200X	Infectious Disease Physician	159784-1	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1063551497
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROSS G HEWITT MD

Provider Business Mailing Address
First Line	:	16 E 16TH ST
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10003-3105
Country	:	US
Telephone Number	:	212-924-7744
Fax Number	:	212-989-6170

Provider Business Practice Location Address
First Line	:	1824 MADISON AVE
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10035-3832
Country	:	US
Telephone Number	:	212-423-4500
Fax Number	:	646-770-8405

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/05/2007
Last Update Date	:	04/17/2013

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