Healthcare Provider Details

I. General information

NPI: 1063551497
Provider Name (Legal Business Name): ROSS G HEWITT MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/05/2007
Last Update Date: 04/17/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1824 MADISON AVE
NEW YORK NY
10035-3832
US

IV. Provider business mailing address

16 E 16TH ST
NEW YORK NY
10003-3105
US

V. Phone/Fax

Practice location:
  • Phone: 212-423-4500
  • Fax: 646-770-8405
Mailing address:
  • Phone: 212-924-7744
  • Fax: 212-989-6170

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number159784-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: