Provider Demographics
NPI:1639645534
Name:HEWWING, SAMANTHA (L AC, DACM)
Entity Type:Individual
Prefix:DR
First Name:SAMANTHA
Middle Name:
Last Name:HEWWING
Suffix:
Gender:F
Credentials:L AC, DACM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:928 BROADWAY STE 1104
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10010-8112
Mailing Address - Country:US
Mailing Address - Phone:917-267-8389
Mailing Address - Fax:
Practice Address - Street 1:928 BROADWAY STE 1104
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-8112
Practice Address - Country:US
Practice Address - Phone:917-837-8384
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-17
Last Update Date:2019-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006397-1171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist