Healthcare Provider Details

I. General information

NPI: 1205303344
Provider Name (Legal Business Name): ANNE ELIZABETH HEWITT FMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANNE ELIZABETH PESARESI

II. Dates (important events)

Enumeration Date: 10/26/2018
Last Update Date: 08/20/2021
Certification Date: 08/20/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

768 DELAWARE AVE
BUFFALO NY
14209-2006
US

IV. Provider business mailing address

701 LENOX AVE
ONEIDA NY
13421-1500
US

V. Phone/Fax

Practice location:
  • Phone: 716-882-3151
  • Fax: 716-886-4002
Mailing address:
  • Phone: 315-363-9281
  • Fax: 315-363-9286

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number402490
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: