Provider Demographics
NPI:1508863663
Name:VESSA, PAUL P (MD)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:P
Last Name:VESSA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1 ROBERTSON DRIVE
Mailing Address - Street 2:SUITE 11
Mailing Address - City:BEDMINSTER
Mailing Address - State:NJ
Mailing Address - Zip Code:07921
Mailing Address - Country:US
Mailing Address - Phone:908-234-9200
Mailing Address - Fax:908-722-6318
Practice Address - Street 1:1 ROBERTSON DRIVE
Practice Address - Street 2:SUITE 11
Practice Address - City:BEDMINSTER
Practice Address - State:NJ
Practice Address - Zip Code:07921
Practice Address - Country:US
Practice Address - Phone:908-234-9200
Practice Address - Fax:908-722-6318
Is Sole Proprietor?:No
Enumeration Date:2005-07-05
Last Update Date:2016-11-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA05026500207X00000X
NJ25MA05028500207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
F42030Medicare UPIN
NJ5654301Medicaid
NJ105060BMNMedicare PIN