MEDICARE: MR. VINCENT DEPAUL HESS LPN

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	164W00000X	Licensed Practical Nurse	26NP05121800	NJ

General Provider Information

NPI Number	:	1497727507
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. VINCENT DEPAUL HESS LPN

Provider Business Mailing Address
First Line	:	6 MICHELLE LN
Second Line	:
City	:	BAYVILLE
State	:	NJ
Zip	:	08721-1272
Country	:	US
Telephone Number	:	732-606-0187
Fax Number	:

Provider Business Practice Location Address
First Line	:	5250 NEW JERSEY AVE
Second Line	:	SRC
City	:	FT DIX-
State	:	NJ
Zip	:	08640
Country	:	US
Telephone Number	:	609-562-5763
Fax Number	:

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

Provider Enumeration Date	:	02/02/2006
Last Update Date	:	07/08/2007

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