Provider Demographics
NPI:1013017490
Name:LESTER, RICHARD DANA (MD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:DANA
Last Name:LESTER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:132 E 76 ST
Mailing Address - Street 2:STE 2D
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021
Mailing Address - Country:US
Mailing Address - Phone:212-861-4455
Mailing Address - Fax:212-288-3776
Practice Address - Street 1:132 E 76 ST
Practice Address - Street 2:STE 2D
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021
Practice Address - Country:US
Practice Address - Phone:212-861-4455
Practice Address - Fax:212-861-4455
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY131255207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00682682Medicaid
C09778Medicare UPIN
43A681Medicare ID - Type Unspecified