Provider Demographics
NPI:1508857848
Name:LESTER, BRIAN W (MD)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:W
Last Name:LESTER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:235 CYPRESS STREEET
Mailing Address - Street 2:SUITE 200
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02445
Mailing Address - Country:US
Mailing Address - Phone:617-277-0800
Mailing Address - Fax:617-277-0899
Practice Address - Street 1:235 CYPRESS STREEET
Practice Address - Street 2:SUITE 200
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02445
Practice Address - Country:US
Practice Address - Phone:617-277-0800
Practice Address - Fax:617-277-0899
Is Sole Proprietor?:No
Enumeration Date:2005-11-04
Last Update Date:2017-03-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD426329207N00000X
MA223638207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAI39146Medicare UPIN
MAA39034Medicare ID - Type Unspecified