Provider Demographics
NPI:1588649768
Name:KESSLER ORTHOTIC AND PROSTHETIC INC
Entity type:Organization
Organization Name:KESSLER ORTHOTIC AND PROSTHETIC INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR ORTHOTICS PROSTHETICS
Authorized Official - Prefix:MR
Authorized Official - First Name:GUS
Authorized Official - Middle Name:A
Authorized Official - Last Name:EPPINGER
Authorized Official - Suffix:
Authorized Official - Credentials:CPO LPO-NJ
Authorized Official - Phone:973-992-9700
Mailing Address - Street 1:11 MICROLAB RD
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07039
Mailing Address - Country:US
Mailing Address - Phone:973-992-9700
Mailing Address - Fax:973-533-1015
Practice Address - Street 1:11 MICROLAB RD
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:NJ
Practice Address - Zip Code:07039
Practice Address - Country:US
Practice Address - Phone:973-992-9700
Practice Address - Fax:973-533-1015
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotistGroup - Single Specialty
Not Answered224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetistGroup - Single Specialty
Not Answered225000000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotic FitterGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0074268Medicaid
=========OtherTIN
5439630001Medicare ID - Type Unspecified