Provider Demographics
NPI:1225023880
Name:LESTER, DAVID I (DC)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:I
Last Name:LESTER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:652 ROUTE 299 STE 202
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND
Mailing Address - State:NY
Mailing Address - Zip Code:12528-2926
Mailing Address - Country:US
Mailing Address - Phone:845-255-3300
Mailing Address - Fax:845-255-4220
Practice Address - Street 1:652 ROUTE 299 STE 202
Practice Address - Street 2:
Practice Address - City:HIGHLAND
Practice Address - State:NY
Practice Address - Zip Code:12528-2926
Practice Address - Country:US
Practice Address - Phone:845-255-3300
Practice Address - Fax:845-255-4220
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-20
Last Update Date:2022-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX005615-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYCO-5615-4OtherWORKERS COMP AUTH #
NYX34842Medicare ID - Type Unspecified