Provider Demographics
NPI:1457470593
Name:HESSE, KENT STEVEN (MD)
Entity Type:Individual
Prefix:DR
First Name:KENT
Middle Name:STEVEN
Last Name:HESSE
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 1:138 RUSSELL ST
Mailing Address - Street 2:
Mailing Address - City:HADLEY
Mailing Address - State:MA
Mailing Address - Zip Code:01035-9533
Mailing Address - Country:US
Mailing Address - Phone:413-587-4680
Mailing Address - Fax:413-587-4682
Practice Address - Street 1:138 RUSSELL ST
Practice Address - Street 2:
Practice Address - City:HADLEY
Practice Address - State:MA
Practice Address - Zip Code:01035-9533
Practice Address - Country:US
Practice Address - Phone:413-587-4680
Practice Address - Fax:413-587-4682
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-28
Last Update Date:2008-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT42-0010768208D00000X
NY154574-1208D00000X
MA232987208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAVN3629Medicare PIN
MAE44856Medicare UPIN