Provider Demographics
NPI:1427043066
Name:BESSER, LOUIS M (MD FACC)
Entity Type:Individual
Prefix:
First Name:LOUIS
Middle Name:M
Last Name:BESSER
Suffix:
Gender:M
Credentials:MD FACC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 RALPH PL
Mailing Address - Street 2:SUITE 310
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10304-4419
Mailing Address - Country:US
Mailing Address - Phone:718-442-1777
Mailing Address - Fax:718-448-5260
Practice Address - Street 1:11 RALPH PL
Practice Address - Street 2:SUITE 310
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10304-4419
Practice Address - Country:US
Practice Address - Phone:718-442-1777
Practice Address - Fax:718-448-5260
Is Sole Proprietor?:No
Enumeration Date:2005-09-20
Last Update Date:2010-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY156000207R00000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01107331Medicaid
NY37E431Medicare ID - Type Unspecified
NY01107331Medicaid