Provider Demographics
NPI:1285808105
Name:EWA, JOSEPH FRANCIS (MD)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:FRANCIS
Last Name:EWA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:149 ST.NICHOLAS AVE.
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11237-1518
Mailing Address - Country:US
Mailing Address - Phone:718-246-9166
Mailing Address - Fax:718-715-1302
Practice Address - Street 1:149 ST.NICHOLAS AVE.
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11237
Practice Address - Country:US
Practice Address - Phone:718-246-9166
Practice Address - Fax:718-715-1302
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-22
Last Update Date:2014-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1803952084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
09L101Medicare UPIN