Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208D00000X | General Practice Physician | 282294 | NY |
NPI | 1033401849 |
---|---|
Provider Name | Dr. Andrew Kesselman |
First Address | New York, NY 10065-4870 |
Second Address | New York, NY 10065-4870 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/05/2011 |
Last Update Date | 15/03/2019 |