Provider Demographics
NPI:1508957176
Name:RECHTER, LESLEY (MD)
Entity Type:Individual
Prefix:DR
First Name:LESLEY
Middle Name:
Last Name:RECHTER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:54 BIRCHWOOD PARK DR
Mailing Address - Street 2:
Mailing Address - City:JERICHO
Mailing Address - State:NY
Mailing Address - Zip Code:11753-2202
Mailing Address - Country:US
Mailing Address - Phone:516-933-6850
Mailing Address - Fax:516-933-2157
Practice Address - Street 1:54 BIRCHWOOD PARK DR
Practice Address - Street 2:
Practice Address - City:JERICHO
Practice Address - State:NY
Practice Address - Zip Code:11753-2202
Practice Address - Country:US
Practice Address - Phone:516-933-6850
Practice Address - Fax:516-933-2157
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY131177207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYB77642Medicare UPIN
NY15A151Medicare ID - Type Unspecified