Provider Demographics
NPI:1487961546
Name:HESS ANKLE AND FOOT CENTER, LLC
Entity type:Organization
Organization Name:HESS ANKLE AND FOOT CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:A
Authorized Official - Last Name:HESS
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:856-241-1880
Mailing Address - Street 1:300 LEXINGTON RD BLDG B
Mailing Address - Street 2:SUITE 230
Mailing Address - City:SWEDESBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:08085-1278
Mailing Address - Country:US
Mailing Address - Phone:856-241-1880
Mailing Address - Fax:856-241-9986
Practice Address - Street 1:300 LEXINGTON RD BLDG B
Practice Address - Street 2:SUITE 230
Practice Address - City:SWEDESBORO
Practice Address - State:NJ
Practice Address - Zip Code:08085-1278
Practice Address - Country:US
Practice Address - Phone:856-241-1880
Practice Address - Fax:856-241-9986
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-09
Last Update Date:2011-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMD01175213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJT73091Medicare UPIN