Provider Demographics
NPI:1255453700
Name:BAPTISTE, KESNOLD (DC)
Entity type:Individual
Prefix:DR
First Name:KESNOLD
Middle Name:
Last Name:BAPTISTE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:139 W 7TH AVE
Mailing Address - Street 2:
Mailing Address - City:ROSELLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07203-1939
Mailing Address - Country:US
Mailing Address - Phone:908-245-2131
Mailing Address - Fax:908-587-9114
Practice Address - Street 1:439 MAIN ST
Practice Address - Street 2:SUITE 102
Practice Address - City:ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07050-1523
Practice Address - Country:US
Practice Address - Phone:973-675-8700
Practice Address - Fax:973-675-8701
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00641500111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor