Provider Demographics
NPI:1891792180
Name:KESLONSKY, ADAM JON (DPM)
Entity Type:Individual
Prefix:
First Name:ADAM
Middle Name:JON
Last Name:KESLONSKY
Suffix:
Gender:M
Credentials:DPM
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Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:180 EAST PULASKI RD
Mailing Address - Street 2:HUNTINGTON MEDICAL GROUP - DR. ADAM KESLONSKY
Mailing Address - City:HUNTINGTON STATION
Mailing Address - State:NY
Mailing Address - Zip Code:11746
Mailing Address - Country:US
Mailing Address - Phone:631-425-2244
Mailing Address - Fax:631-425-2158
Practice Address - Street 1:180 E PULASKI RD
Practice Address - Street 2:
Practice Address - City:HUNTINGTON STATION
Practice Address - State:NY
Practice Address - Zip Code:11746-1915
Practice Address - Country:US
Practice Address - Phone:631-425-2244
Practice Address - Fax:631-425-2158
Is Sole Proprietor?:No
Enumeration Date:2005-07-01
Last Update Date:2021-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN005478-1213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02071263Medicaid
NY02071263Medicaid
NYPB6761Medicare PIN