Provider Demographics
NPI:1518352731
Name:KESTENBAUM, DAVID C (MD, RPVI,)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:C
Last Name:KESTENBAUM
Suffix:
Gender:M
Credentials:MD, RPVI,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:465 SOUTH ST STE 103
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07960-6442
Mailing Address - Country:US
Mailing Address - Phone:973-971-6602
Mailing Address - Fax:
Practice Address - Street 1:100 MADISON AVE
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07960-6136
Practice Address - Country:US
Practice Address - Phone:973-971-5370
Practice Address - Fax:973-290-7294
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-03
Last Update Date:2025-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2962892085R0204X, 208D00000X
NJ25MA110916002085R0204X, 2085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional RadiologyGroup - Single Specialty
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice