Healthcare Provider Details

I. General information

NPI: 1427043066
Provider Name (Legal Business Name): LOUIS M BESSER MD FACC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2005
Last Update Date: 10/06/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11 RALPH PL SUITE 310
STATEN ISLAND NY
10304-4419
US

IV. Provider business mailing address

11 RALPH PL SUITE 310
STATEN ISLAND NY
10304-4419
US

V. Phone/Fax

Practice location:
  • Phone: 718-442-1777
  • Fax: 718-448-5260
Mailing address:
  • Phone: 718-442-1777
  • Fax: 718-448-5260

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number156000
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number156000
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: