Provider Demographics
NPI:1215941802
Name:MEISLER, KENNETH R (DPM)
Entity type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:R
Last Name:MEISLER
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 E 86TH ST
Mailing Address - Street 2:STE. 402
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028-3003
Mailing Address - Country:US
Mailing Address - Phone:212-628-4444
Mailing Address - Fax:212-570-6120
Practice Address - Street 1:210 E 86TH ST
Practice Address - Street 2:STE. 402
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10028-3003
Practice Address - Country:US
Practice Address - Phone:212-628-4444
Practice Address - Fax:212-570-6120
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-28
Last Update Date:2014-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002559213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00439703Medicaid
NY4105300001Medicare NSC
NYT50798Medicare UPIN
NY00439703Medicaid