Provider Demographics
NPI:1902196132
Name:HEWITT-SIMEON, MARY HELEN (LPN)
Entity Type:Individual
Prefix:MISS
First Name:MARY
Middle Name:HELEN
Last Name:HEWITT-SIMEON
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9918 AVENUE M
Mailing Address - Street 2:PH
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11236-5041
Mailing Address - Country:US
Mailing Address - Phone:347-673-7126
Mailing Address - Fax:
Practice Address - Street 1:9918 AVENUE M
Practice Address - Street 2:PH
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11236-5041
Practice Address - Country:US
Practice Address - Phone:347-673-7126
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-08
Last Update Date:2011-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY267558-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse