Provider Demographics
NPI:1154324523
Name:KESTLINGER, STEVEN (PA-C)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:
Last Name:KESTLINGER
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2315 ROUTE 34
Mailing Address - Street 2:
Mailing Address - City:MANASQUAN
Mailing Address - State:NJ
Mailing Address - Zip Code:08736-1444
Mailing Address - Country:US
Mailing Address - Phone:732-974-0404
Mailing Address - Fax:732-449-4271
Practice Address - Street 1:2315 ROUTE 34
Practice Address - Street 2:
Practice Address - City:MANASQUAN
Practice Address - State:NJ
Practice Address - Zip Code:08736-1444
Practice Address - Country:US
Practice Address - Phone:732-974-0404
Practice Address - Fax:732-449-4271
Is Sole Proprietor?:No
Enumeration Date:2005-05-31
Last Update Date:2024-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MP00006600363A00000X, 363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ076792BMZOtherMEDICARE ID-TYPE UNSPECIFIES
NJ222721753OtherTAX ID NUMBER
NJ222721753OtherTAX ID NUMBER