Provider Demographics
NPI:1740661222
Name:HEWITT, WINIFRED (MED)
Entity type:Individual
Prefix:
First Name:WINIFRED
Middle Name:
Last Name:HEWITT
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:289 EMPIRE BLVD
Mailing Address - Street 2:APT.3M
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11225-3550
Mailing Address - Country:US
Mailing Address - Phone:347-685-8025
Mailing Address - Fax:
Practice Address - Street 1:289 EMPIRE BLVD
Practice Address - Street 2:APT.3M
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11225-3550
Practice Address - Country:US
Practice Address - Phone:347-685-8025
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-10
Last Update Date:2015-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY709835174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist