Provider Demographics
NPI:1558637132
Name:KESSLER, KAREN RIESS (CPNP)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:RIESS
Last Name:KESSLER
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:131 S PLAISTED AVE
Mailing Address - Street 2:
Mailing Address - City:HAUPPAUGE
Mailing Address - State:NY
Mailing Address - Zip Code:11788-2753
Mailing Address - Country:US
Mailing Address - Phone:631-361-7631
Mailing Address - Fax:
Practice Address - Street 1:650 E MAIN ST
Practice Address - Street 2:
Practice Address - City:BAY SHORE
Practice Address - State:NY
Practice Address - Zip Code:11706-8503
Practice Address - Country:US
Practice Address - Phone:631-666-1300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-28
Last Update Date:2013-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY382278363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics