1851333827 NPI number — DR. PAUL A KESSELMAN DPM

Table of content: DR. PAUL A KESSELMAN DPM (NPI 1851333827)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1851333827 NPI number — DR. PAUL A KESSELMAN DPM

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KESSELMAN
Provider First Name:
PAUL
Provider Middle Name:
A
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DPM
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1851333827
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/16/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
224 W HENRIETTA AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
OCEANSIDE
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11572-5054
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
718-338-7878
Provider Business Mailing Address Fax Number:
718-338-7879

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
224 W HENRIETTA AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
OCEANSIDE
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11572-5054
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
516-457-6959
Provider Business Practice Location Address Fax Number:
347-382-9388
Provider Enumeration Date:
06/12/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 213ES0103X , with the licence number:  003251 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 112613550 . This is a "UNITED HEALTH CARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 112613550 . This is a "1199 HEALTH CARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: DS511 . This is a "OXFORD HEALTH PLANS" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 00697145 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 112613550 . This is a "FAMILY HEALTH PLUS" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 003251-NY . This is a "1199 SEIU HOSPITAL & HEAL" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 112613550 . This is a "AETNA" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 293460201 . This is a "HEALTH PLUS" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 3C5835 . This is a "HEALTH NET ID" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 78559 . This is a "GHI" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: N003251-A69 . This is a "HEALTH PLUS Q 1199 HOMECA" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 293460101 . This is a "HEALTH PLUS" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 003251-NY . This is a "1199 NBF HOME HEALTH" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 112613550 . This is a "CIGNA HEALTH PLANS" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 137254 . This is a "UNITED HEALTH CARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




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