Healthcare Provider Details

I. General information

NPI: 1659673861
Provider Name (Legal Business Name): KESSLER INSTITUTE OF REHABILITATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/19/2010
Last Update Date: 05/30/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1199 PLEASANT VALLEY WAY
WEST ORANGE NJ
07052-1424
US

IV. Provider business mailing address

1199 PLEASANT VALLEY VAY
WEST ORANGE NJ
07052
US

V. Phone/Fax

Practice location:
  • Phone: 917-282-6066
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251300000X
TaxonomyLocal Education Agency (LEA)
License Number018739
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code283X00000X
TaxonomyRehabilitation Hospital
License Number35SI00506300
License Number StateNJ

VIII. Authorized Official

Name: DR. SCOTT TESSLER
Title or Position: PSYCHOLOGIST
Credential: PSY.D.
Phone: 917-282-6066