Provider Demographics
NPI:1831243708
Name:KESARWALA, HEMANT H (MD)
Entity type:Individual
Prefix:DR
First Name:HEMANT
Middle Name:H
Last Name:KESARWALA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3084 STATEROUTE 27
Mailing Address - Street 2:SUITE 6
Mailing Address - City:KENDALL PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:08824
Mailing Address - Country:US
Mailing Address - Phone:732-821-0595
Mailing Address - Fax:
Practice Address - Street 1:3084 STATE ROUTE 27
Practice Address - Street 2:SUITE 6
Practice Address - City:KENDALL PARK
Practice Address - State:NJ
Practice Address - Zip Code:08824-1657
Practice Address - Country:US
Practice Address - Phone:732-821-0595
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA31872207K00000X, 2080P0208X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Not Answered2080P0208XAllopathic & Osteopathic PhysiciansPediatricsPediatric Infectious Diseases
Provider Identifiers
StateIdentifier IDID TypeIssuer
KE430589Medicare ID - Type Unspecified
A 81605Medicare UPIN