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General NPI Number Information
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NPI Number | 1396713988
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Entity Type | Individual
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Provider Name | EDMUND KESSLER M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/09/2006
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Last Update Date | 10/15/2014
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Provider Practice Location Address
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Address Line | 1000 NORTHERN BLVD SUITE 250
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City | GREAT NECK
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State | NY
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Zip | 11021-5312
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Country | US
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Telephone | 516-489-9000
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Fax | 516-498-9005
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Provider Business Mailing Address
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Address Line | PO BOX 9007 ATT: PHYSICIAN BILLING
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City | OCEANSIDE
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State | NY
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Zip | 11572-9007
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Country | US
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Telephone | 516-255-1616
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Fax | 516-255-4672
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 197699
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License Number State | NY
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