Provider Demographics
NPI:1417496555
Name:LESSER, CAROL (NP-C)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:
Last Name:LESSER
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 SECOND AVE
Mailing Address - Street 2:BOSTON IVF
Mailing Address - City:WALTHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02451
Mailing Address - Country:US
Mailing Address - Phone:617-877-9064
Mailing Address - Fax:781-434-6447
Practice Address - Street 1:93 EVANS RD
Practice Address - Street 2:
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02445-2117
Practice Address - Country:US
Practice Address - Phone:617-877-9064
Practice Address - Fax:781-434-6447
Is Sole Proprietor?:No
Enumeration Date:2017-02-22
Last Update Date:2017-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA139034363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health