Provider Demographics
NPI:1982846200
Name:HEWITT PSYCHIATRIC PC
Entity Type:Organization
Organization Name:HEWITT PSYCHIATRIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:L
Authorized Official - Last Name:HEWITT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:856-547-1166
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-01
Last Update Date:2009-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA340362084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty