MEDICARE: DR. BARRY MARK KESSLER MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	25MA03730400	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1902882855
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BARRY MARK KESSLER MD

Provider Business Mailing Address
First Line	:	6529 BLACK HORSE PIKE
Second Line	:
City	:	EGG HARBOR TOWNSHIP
State	:	NJ
Zip	:	08234-4509
Country	:	US
Telephone Number	:	609-645-8500
Fax Number	:	609-645-2574

Provider Business Practice Location Address
First Line	:	6529 BLACK HORSE PIKE
Second Line	:
City	:	EGG HARBOR TOWNSHIP
State	:	NJ
Zip	:	08234-4509
Country	:	US
Telephone Number	:	609-645-8500
Fax Number	:	609-645-2574

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/21/2005
Last Update Date	:	07/14/2007

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