Healthcare Provider Details

I. General information

NPI: 1003503913
Provider Name (Legal Business Name): LAURA KESSLER PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/20/2023
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28 RYDER AVE
DIX HILLS NY
11746-6123
US

IV. Provider business mailing address

28 RYDER AVE
DIX HILLS NY
11746-6123
US

V. Phone/Fax

Practice location:
  • Phone: 516-360-9378
  • Fax:
Mailing address:
  • Phone: 516-360-9378
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number026821
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: