Healthcare Provider Details

I. General information

NPI: 1649320102
Provider Name (Legal Business Name): MYLES A KESSLER AUD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/10/2007
Last Update Date: 04/07/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

46 PRINCE ST STE 6
NEW HAVEN CT
06519-1600
US

IV. Provider business mailing address

31 BROADWAY
NORTH HAVEN CT
06473-2304
US

V. Phone/Fax

Practice location:
  • Phone: 203-752-1726
  • Fax: 203-752-1838
Mailing address:
  • Phone: 203-234-1324
  • Fax: 203-239-3047

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number000209
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number000209
License Number StateCT
# 3
Primary TaxonomyN
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number000209
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: