Provider Demographics
NPI:1326020165
Name:KESSLER, HOWARD (OD)
Entity Type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:
Last Name:KESSLER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5330 NESCONSET HWY
Mailing Address - Street 2:
Mailing Address - City:PORT JEFFERSON STATION
Mailing Address - State:NY
Mailing Address - Zip Code:11776-2049
Mailing Address - Country:US
Mailing Address - Phone:631-331-3883
Mailing Address - Fax:631-642-1506
Practice Address - Street 1:5330 NESCONSET HWY
Practice Address - Street 2:
Practice Address - City:PORT JEFFERSON STATION
Practice Address - State:NY
Practice Address - Zip Code:11776-2049
Practice Address - Country:US
Practice Address - Phone:631-331-3883
Practice Address - Fax:631-642-1506
Is Sole Proprietor?:No
Enumeration Date:2005-11-17
Last Update Date:2007-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY3882152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00715077Medicaid
NY00715077Medicaid
NYC2A381Medicare PIN