Provider Demographics
NPI:1043503246
Name:KESSLER, JONATHAN D (MD)
Entity Type:Individual
Prefix:
First Name:JONATHAN
Middle Name:D
Last Name:KESSLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:2914 ELMWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:KENMORE
Mailing Address - State:NY
Mailing Address - Zip Code:14217-1332
Mailing Address - Country:US
Mailing Address - Phone:716-875-6700
Mailing Address - Fax:716-875-6853
Practice Address - Street 1:2914 ELMWOOD AVE
Practice Address - Street 2:
Practice Address - City:KENMORE
Practice Address - State:NY
Practice Address - Zip Code:14217-1332
Practice Address - Country:US
Practice Address - Phone:716-875-6700
Practice Address - Fax:716-875-6853
Is Sole Proprietor?:No
Enumeration Date:2011-05-20
Last Update Date:2015-12-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY274963207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
J400157081Medicare PIN