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NPI 1336769447

NPI 1336769447 : FREDERICK MICHAEL KAESTEL DPM : SHREWSBURY, MA

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General NPI Number Information
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    NPI Number           |    1336769447
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    Entity Type          |    Individual 
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    Provider Name        |    FREDERICK MICHAEL KAESTEL DPM
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    04/18/2020
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    Last Update Date     |    03/20/2023
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Provider Practice Location Address
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    Address Line         |    626 MAIN ST 
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    City                 |    SHREWSBURY
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    State                |    MA
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    Zip                  |    01545-5639
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    Country              |    US
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    Telephone            |    508-842-7910
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    27005 76TH AVE BLDG C 
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    City                 |    NEW HYDE PARK
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    State                |    NY
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    Zip                  |    11040-1402
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    213ES0103X
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    Taxonomy Name        |    Foot & Ankle Surgery Podiatrist
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    License Number       |    25MD00365200
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    License Number State |    NJ
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Taxonomy #2
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    Taxonomy Code        |    390200000X
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    Taxonomy Name        |    Student in an Organized Health Care Education/Training Program
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    License Number       |    
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    License Number State |    
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Taxonomy #3
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    Taxonomy Code        |    213ES0103X
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    Taxonomy Name        |    Foot & Ankle Surgery Podiatrist
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    License Number       |    2535
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    License Number State |    MA
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