Provider Demographics
NPI:1780826388
Name:DIAL HEWLETT JR.,M.D.,P.C.
Entity Type:Organization
Organization Name:DIAL HEWLETT JR.,M.D.,P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:DIAL
Authorized Official - Middle Name:
Authorized Official - Last Name:HEWLETT
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD, PC
Authorized Official - Phone:914-337-2223
Mailing Address - Street 1:22 SAGAMORE RD
Mailing Address - Street 2:STE: E
Mailing Address - City:BRONXVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:10708-1541
Mailing Address - Country:US
Mailing Address - Phone:914-337-2223
Mailing Address - Fax:914-337-0200
Practice Address - Street 1:22 SAGAMORE RD
Practice Address - Street 2:STE: E
Practice Address - City:BRONXVILLE
Practice Address - State:NY
Practice Address - Zip Code:10708-1541
Practice Address - Country:US
Practice Address - Phone:914-337-2223
Practice Address - Fax:914-337-0200
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-27
Last Update Date:2009-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY138794207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1043299894OtherNPI
NYB17386Medicare UPIN
NY64A292Medicare PIN