Provider Demographics
NPI:1386671568
Name:HESS, LINCOLN RA (MD)
Entity Type:Individual
Prefix:DR
First Name:LINCOLN
Middle Name:RA
Last Name:HESS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1235 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-1759
Mailing Address - Country:US
Mailing Address - Phone:212-987-6515
Mailing Address - Fax:
Practice Address - Street 1:1235 PARK AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-1759
Practice Address - Country:US
Practice Address - Phone:212-987-6515
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY155065-12084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00245221Medicaid
NY24L441Medicare ID - Type Unspecified