Provider Demographics
NPI:1548310774
Name:THE DR MARTIN JAY KESSLER MEDICAL SERVICES LLC
Entity type:Organization
Organization Name:THE DR MARTIN JAY KESSLER MEDICAL SERVICES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:MARTIN
Authorized Official - Middle Name:JAY
Authorized Official - Last Name:KESSLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:856-696-0669
Mailing Address - Street 1:234 W LANDIS AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:VINELAND
Mailing Address - State:NJ
Mailing Address - Zip Code:08360-8109
Mailing Address - Country:US
Mailing Address - Phone:856-696-0669
Mailing Address - Fax:
Practice Address - Street 1:234 W LANDIS AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:VINELAND
Practice Address - State:NJ
Practice Address - Zip Code:08360-8109
Practice Address - Country:US
Practice Address - Phone:856-696-0669
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA06177300207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
0022654000OtherAMERIHEALTH
1001812OtherCIGNA
19827OtherUNIVERSITY HEALTH PLAN
F11051OtherFIRST OPTION
FIRST HEALTHOther1040578
UNITED HEALTHCAREOther89990
NJ6447601Medicaid
8223340OtherGHI
NJ132049OtherHORIZON BC BS
2657461OtherAETNA
0K7286OtherHEALTH NET
36924OtherAMERIGROUP
JP141OtherOXFORD
8223340OtherGHI
NJ6447601Medicaid