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NPI Code Detail

MEDICARE: DR. VINCENT JOSEPH ADESSO PHD

MEDICARE: DR. VINCENT JOSEPH ADESSO PHD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC0700XClinical Psychologist608057WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1316907694
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. VINCENT JOSEPH ADESSO PHD
Provider Business Mailing Address
First Line : 5555 NORTH PORT WASHINGTON RD
Second Line : STE 304
City : MILWAUKEE
State : WI
Zip : 53217-4927
Country : US
Telephone Number : 414-967-9552
Fax Number : 414-967-9550
Provider Business Practice Location Address
First Line : 5555 NORTH PORT WASHINGTON RD
Second Line : STE 304
City : MILWAUKEE
State : WI
Zip : 53217-4927
Country : US
Telephone Number : 414-967-9552
Fax Number : 414-967-9550
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/23/2006
Last Update Date : 07/17/2013

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