MEDICARE: JESSE CARROLL BASS

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
1	235Z00000X	Speech-Language Pathologist	41YS00866100	NJ

General Provider Information

NPI Number	:	1124977269
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSE CARROLL BASS

Provider Business Mailing Address
First Line	:	106 WOODLAND AVE
Second Line	:
City	:	EWING
State	:	NJ
Zip	:	08638-2555
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	106 WOODLAND AVE
Second Line	:
City	:	EWING
State	:	NJ
Zip	:	08638-2555
Country	:	US
Telephone Number	:	609-558-0970
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/22/2026
Last Update Date	:	01/22/2026

Similar Medicare Providers

1023947843 — YVETTE L RUE
Practice Location Address:

4 NEW HILLCREST AVE
EWING, NJ
08638-3520

Practice Phone: 609-209-2757
Practice Fax:

1487652889 — PARKSIDE HEALTHCARE, INC.
Practice Location Address:

1450 PARKSIDE AVE , STE 23
EWING, NJ
08638-2946

Practice Phone: 609-882-5200
Practice Fax: 609-882-0370

1942295761 — KATHLEEN M GEKOWSKI MD
Practice Location Address:

1450 PARKSIDE AVENUE , SUITE #4
EWING, NJ
08638

Practice Phone: 609-882-3500
Practice Fax: 609-882-3501

1962485649 — PARKSIDE URGENT CARE, INC
Practice Location Address:

1450 PARKSIDE AVE , SUITE 23
EWING, NJ
08638-2946

Practice Phone: 609-882-5200
Practice Fax: 609-882-0370

1376512749 — MR. J SCOTT DOOLITTLE
Practice Location Address:

1881 N OLDEN AVE
EWING, NJ
08638

Practice Phone: 609-530-0011
Practice Fax: 609-530-0666

1548229693 — MR. MARK D LAURINAITIS
Practice Location Address:

1881 N OLDEN AVE
EWING, NJ
08638

Practice Phone: 609-530-0011
Practice Fax: 609-530-0666

Directions to “ JESSE CARROLL BASS ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.