Provider Demographics
NPI:1558976456
Name:LESTER, HARRIET (MD)
Entity Type:Individual
Prefix:
First Name:HARRIET
Middle Name:
Last Name:LESTER
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 1:15930 ROCKAWAY BLVD # 247
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11434-4848
Mailing Address - Country:US
Mailing Address - Phone:718-553-3300
Mailing Address - Fax:
Practice Address - Street 1:15930 ROCKAWAY BLVD # 247
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11434-4848
Practice Address - Country:US
Practice Address - Phone:718-553-3300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-09
Last Update Date:2020-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY165295-1405300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes405300000XOther Service ProvidersPrevention Professional