Provider Demographics
NPI:1528040698
Name:HESSE, KATHERINE AILENE (MD, MSW)
Entity Type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:AILENE
Last Name:HESSE
Suffix:
Gender:F
Credentials:MD, MSW
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Mailing Address - Street 1:PO BOX 9142
Mailing Address - Street 2:MASS. GENERAL PHYSICIAN ORGANIZATION
Mailing Address - City:CHARLESTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02129-9142
Mailing Address - Country:US
Mailing Address - Phone:617-726-4600
Mailing Address - Fax:617-228-6306
Practice Address - Street 1:100 CHARLES RIVER PLZ
Practice Address - Street 2:STE 501 CPZ 502, MGH SENIOR HEALTH
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-2723
Practice Address - Country:US
Practice Address - Phone:617-726-4600
Practice Address - Fax:617-228-6306
Is Sole Proprietor?:No
Enumeration Date:2005-11-15
Last Update Date:2012-07-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA47630207R00000X, 207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA708223OtherTUFTS HEALTH PLAN
MAE05771OtherBCBS OF MA
MA0162175Medicaid
MA708223OtherTUFTS HEALTH PLAN
MA0162175Medicaid