Provider Demographics
NPI:1245293885
Name:KESLER, MICHAEL (DPM)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:
Last Name:KESLER
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 HAMBURG TPKE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:WAYNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07470-2048
Mailing Address - Country:US
Mailing Address - Phone:973-835-8350
Mailing Address - Fax:973-835-8340
Practice Address - Street 1:601 HAMBURG TPKE
Practice Address - Street 2:SUITE 100
Practice Address - City:WAYNE
Practice Address - State:NJ
Practice Address - Zip Code:07470-2048
Practice Address - Country:US
Practice Address - Phone:973-835-8350
Practice Address - Fax:973-835-8340
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-06
Last Update Date:2010-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN006093-1213ES0103X
NJ25MD00286800213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYPK3141Medicare ID - Type Unspecified
NYV07821Medicare UPIN
NJ119857XL3Medicare PIN