Healthcare Provider Details

I. General information

NPI: 1245304054
Provider Name (Legal Business Name): MICHAEL KESLER, D.P.M., P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/20/2006
Last Update Date: 02/13/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2035 HAMBURG TPKE SUITE G
WAYNE NJ
07470-6251
US

IV. Provider business mailing address

2930 W 5TH ST BLDG# 6A APT# 20J
BROOKLYN NY
11224-4836
US

V. Phone/Fax

Practice location:
  • Phone: 973-835-8350
  • Fax: 973-835-8340
Mailing address:
  • Phone: 718-946-2103
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberN006093
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number25MD00286800
License Number StateNJ

VIII. Authorized Official

Name: DR. MICHAEL KESLER
Title or Position: DIRECTOR
Credential: D.P.M.
Phone: 917-686-0904