Provider Demographics
NPI:1952425209
Name:HESS, ELIZABETH ANNE (PT)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:ANNE
Last Name:HESS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MS
Other - First Name:ELIZABETH
Other - Middle Name:ANNE
Other - Last Name:O'CONNOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:385 STATE ROUTE 24
Mailing Address - Street 2:3-G
Mailing Address - City:CHESTER
Mailing Address - State:NJ
Mailing Address - Zip Code:07930-2918
Mailing Address - Country:US
Mailing Address - Phone:908-879-8787
Mailing Address - Fax:908-879-3069
Practice Address - Street 1:385 STATE ROUTE 24
Practice Address - Street 2:3-G
Practice Address - City:CHESTER
Practice Address - State:NJ
Practice Address - Zip Code:07930-2918
Practice Address - Country:US
Practice Address - Phone:908-879-8787
Practice Address - Fax:908-879-3069
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00412200225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJOC563565Medicare ID - Type UnspecifiedPHYSICAL THERAPY PROVIDER