Provider Demographics
NPI:1790779908
Name:LESSER, MARTIN (DO)
Entity Type:Individual
Prefix:
First Name:MARTIN
Middle Name:
Last Name:LESSER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1236 MAIN ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:HOLYOKE
Mailing Address - State:MA
Mailing Address - Zip Code:01040-5370
Mailing Address - Country:US
Mailing Address - Phone:413-536-7040
Mailing Address - Fax:413-536-7254
Practice Address - Street 1:1236 MAIN ST
Practice Address - Street 2:SUITE 201
Practice Address - City:HOLYOKE
Practice Address - State:MA
Practice Address - Zip Code:01040-5370
Practice Address - Country:US
Practice Address - Phone:413-536-7040
Practice Address - Fax:413-536-7254
Is Sole Proprietor?:No
Enumeration Date:2005-09-01
Last Update Date:2016-07-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA75865207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAE85236Medicare UPIN