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General NPI Number Information
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NPI Number | 1457891434
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Entity Type | Organization
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Legal Business Name | KESSLER MEDICAL LLC
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Dates
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Enumeration Date | 02/24/2017
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Last Update Date | 01/19/2018
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Provider Practice Location Address
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Address Line | 6 BUSINESS PARK DR STE 103
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City | BRANFORD
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State | CT
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Zip | 06405-2988
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Country | US
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Telephone | 475-888-0038
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Fax | 888-974-3861
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Provider Business Mailing Address
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Address Line | PO BOX 958
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City | PORT JEFFERSON STATION
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State | NY
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Zip | 11776-0811
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Country | US
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Telephone | 475-888-0038
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Fax | 888-974-3861
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Authorized Official
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Title or Position | OWNER
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Name | JAMES M KESSLER
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Credential | MD
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Telephone | 475-888-0038
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085N0700X
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Taxonomy Name | Neuroradiology Physician
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License Number | 053293
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License Number State | CT
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