Provider Demographics
NPI:1851333827
Name:KESSELMAN, PAUL A (DPM)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:A
Last Name:KESSELMAN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:224 W HENRIETTA AVE
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11572-5054
Mailing Address - Country:US
Mailing Address - Phone:718-338-7878
Mailing Address - Fax:718-338-7879
Practice Address - Street 1:224 W HENRIETTA AVE
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:NY
Practice Address - Zip Code:11572-5054
Practice Address - Country:US
Practice Address - Phone:516-457-6959
Practice Address - Fax:347-382-9388
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-12
Last Update Date:2022-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003251213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY112613550OtherUNITED HEALTH CARE
NY112613550Other1199 HEALTH CARE
NYDS511OtherOXFORD HEALTH PLANS
NY00697145Medicaid
AL112613550OtherFAMILY HEALTH PLUS
NY003251-NYOther1199 SEIU HOSPITAL & HEAL
NY112613550OtherAETNA
NY293460201OtherHEALTH PLUS
NY3C5835OtherHEALTH NET ID
NY78559OtherGHI
NYN003251-A69OtherHEALTH PLUS Q 1199 HOMECA
NY293460101OtherHEALTH PLUS
NY003251-NYOther1199 NBF HOME HEALTH
NY112613550OtherCIGNA HEALTH PLANS
NY137254OtherUNITED HEALTH CARE
NY78559OtherGHI
NY112613550OtherAETNA
NY78559Medicare PIN