Provider Demographics
NPI:1679670764
Name:NESS, AMEN (MD)
Entity type:Individual
Prefix:
First Name:AMEN
Middle Name:
Last Name:NESS
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:57 RIVER EDGE FARMS RD
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:CT
Mailing Address - Zip Code:06443-2711
Mailing Address - Country:US
Mailing Address - Phone:831-524-0035
Mailing Address - Fax:
Practice Address - Street 1:9300 VALLEY CHILDRENS PL # FE16
Practice Address - Street 2:
Practice Address - City:MADERA
Practice Address - State:CA
Practice Address - Zip Code:93636-8761
Practice Address - Country:US
Practice Address - Phone:559-353-6700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2025-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA208773207VM0101X
CAG49848207VM0101X
VA0101281969207VM0101X
NJ25MA09030000207VM0101X
TXV0485207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZP4309ZMedicare ID - Type Unspecified