Provider Demographics
NPI:1629155544
Name:HEWITT, JAMES L (MD, PA)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:L
Last Name:HEWITT
Suffix:
Gender:M
Credentials:MD, PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:442 WARWICK RD N
Mailing Address - Street 2:
Mailing Address - City:LAWNSIDE
Mailing Address - State:NJ
Mailing Address - Zip Code:08045-1024
Mailing Address - Country:US
Mailing Address - Phone:856-547-1166
Mailing Address - Fax:856-547-5228
Practice Address - Street 1:442 WARWICK RD N
Practice Address - Street 2:
Practice Address - City:LAWNSIDE
Practice Address - State:NJ
Practice Address - Zip Code:08045-1024
Practice Address - Country:US
Practice Address - Phone:856-547-1166
Practice Address - Fax:856-547-5228
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA340362084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry