Provider Demographics
NPI:1821450552
Name:FESSLER, EMILY BAME (MD)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:BAME
Last Name:FESSLER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:165 E 72ND ST APT 15G
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-4348
Mailing Address - Country:US
Mailing Address - Phone:410-499-0127
Mailing Address - Fax:
Practice Address - Street 1:525 E 68TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-4870
Practice Address - Country:US
Practice Address - Phone:212-746-7000
Practice Address - Fax:646-697-0029
Is Sole Proprietor?:No
Enumeration Date:2016-03-22
Last Update Date:2023-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD469518207R00000X
PAMT210675207R00000X, 207RG0300X
NY309250-01207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine