Provider Demographics
NPI:1750129573
Name:HEWITT, ROSHANE
Entity type:Individual
Prefix:
First Name:ROSHANE
Middle Name:
Last Name:HEWITT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24900 ROCKSIDE RD APT 108
Mailing Address - Street 2:
Mailing Address - City:BEDFORD HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44146-1905
Mailing Address - Country:US
Mailing Address - Phone:216-703-8758
Mailing Address - Fax:
Practice Address - Street 1:24900 ROCKSIDE RD APT 108
Practice Address - Street 2:
Practice Address - City:BEDFORD HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44146-1905
Practice Address - Country:US
Practice Address - Phone:216-703-8758
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-16
Last Update Date:2024-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker
No172A00000XOther Service ProvidersDriver