Healthcare Provider Details

I. General information

NPI: 1083791974
Provider Name (Legal Business Name): LOUIS A KESSEL DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/31/2006
Last Update Date: 11/18/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

481 3RD AVE
NEW YORK NY
10016-6021
US

IV. Provider business mailing address

481 3RD AVE
NEW YORK NY
10016-6021
US

V. Phone/Fax

Practice location:
  • Phone: 212-683-4466
  • Fax: 212-685-6605
Mailing address:
  • Phone: 212-683-4466
  • Fax: 212-685-6605

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License NumberX002436-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: