Provider Demographics
NPI:1295393403
Name:LESTER, PATRICK JOSEPH (PA-C)
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:JOSEPH
Last Name:LESTER
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:PATRICK
Other - Middle Name:
Other - Last Name:LOZY-LESTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:601 ELMWOOD AVE BOX 665
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14642-0001
Mailing Address - Country:US
Mailing Address - Phone:855-275-7379
Mailing Address - Fax:
Practice Address - Street 1:4901 LAC DE VILLE BLVD BLDG D
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14618-5647
Practice Address - Country:US
Practice Address - Phone:585-275-5321
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-03
Last Update Date:2020-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY023758363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant