Provider Demographics
NPI:1679304547
Name:KESSLER, CHEREE
Entity type:Individual
Prefix:
First Name:CHEREE
Middle Name:
Last Name:KESSLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 HICKORY CT
Mailing Address - Street 2:
Mailing Address - City:WADING RIVER
Mailing Address - State:NY
Mailing Address - Zip Code:11792-3109
Mailing Address - Country:US
Mailing Address - Phone:631-210-4835
Mailing Address - Fax:
Practice Address - Street 1:1149 OLD COUNTRY RD STE B3
Practice Address - Street 2:
Practice Address - City:RIVERHEAD
Practice Address - State:NY
Practice Address - Zip Code:11901-2060
Practice Address - Country:US
Practice Address - Phone:631-591-2210
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-12
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007228171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist