Provider Demographics
NPI:1588422620
Name:HESCH, PAMELA ROSE
Entity type:Individual
Prefix:MISS
First Name:PAMELA
Middle Name:ROSE
Last Name:HESCH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:131 STAHLEY ST
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:NY
Mailing Address - Zip Code:11717-7603
Mailing Address - Country:US
Mailing Address - Phone:631-513-5856
Mailing Address - Fax:
Practice Address - Street 1:131 STAHLEY ST
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:NY
Practice Address - Zip Code:11717-7603
Practice Address - Country:US
Practice Address - Phone:631-513-5856
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-12
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist