Provider Demographics
NPI:1801256722
Name:HESS, MICHELE P (MSPT)
Entity type:Individual
Prefix:
First Name:MICHELE
Middle Name:P
Last Name:HESS
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:MICHELE
Other - Middle Name:P
Other - Last Name:NOLAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSPT
Mailing Address - Street 1:833 CHESTNUT ST
Mailing Address - Street 2:SUITE 1402
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-4414
Mailing Address - Country:US
Mailing Address - Phone:267-339-3603
Mailing Address - Fax:267-339-3761
Practice Address - Street 1:400 ENTERPRISE DR
Practice Address - Street 2:3RD FLOOR
Practice Address - City:LIMERICK
Practice Address - State:PA
Practice Address - Zip Code:19468-1218
Practice Address - Country:US
Practice Address - Phone:484-932-5060
Practice Address - Fax:610-495-1587
Is Sole Proprietor?:No
Enumeration Date:2016-03-04
Last Update Date:2016-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT006851L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA171384Medicare PIN