Provider Demographics
NPI:1831274711
Name:KESSLER, MARTIN E (MD,FACS)
Entity type:Individual
Prefix:DR
First Name:MARTIN
Middle Name:E
Last Name:KESSLER
Suffix:
Gender:M
Credentials:MD,FACS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:650 NORTHERN BLVD
Mailing Address - Street 2:
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11021-5204
Mailing Address - Country:US
Mailing Address - Phone:516-466-7000
Mailing Address - Fax:516-466-9025
Practice Address - Street 1:650 NORTHERN BLVD
Practice Address - Street 2:
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11021-5204
Practice Address - Country:US
Practice Address - Phone:516-466-7000
Practice Address - Fax:516-466-9025
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY146538174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA64182Medicare UPIN
NYMK076D1910Medicare ID - Type Unspecified