Provider Demographics
NPI:1285992891
Name:GEORGE J KESSLER DO PC
Entity type:Organization
Organization Name:GEORGE J KESSLER DO PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:J
Authorized Official - Last Name:KESSLER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:212-877-7043
Mailing Address - Street 1:165 W END AVE
Mailing Address - Street 2:SUITE 1K
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-5503
Mailing Address - Country:US
Mailing Address - Phone:212-877-7043
Mailing Address - Fax:212-874-4351
Practice Address - Street 1:165 W END AVE
Practice Address - Street 2:SUITE 1K
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-5503
Practice Address - Country:US
Practice Address - Phone:212-877-7043
Practice Address - Fax:212-874-4351
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-02
Last Update Date:2012-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY120686207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY644931Medicare PIN
NYE45910Medicare UPIN