Provider Demographics
NPI:1801856513
Name:LEMAIRE, JEAN T (MD)
Entity Type:Individual
Prefix:
First Name:JEAN
Middle Name:T
Last Name:LEMAIRE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6100 SAINT LAWRENCE CTR
Mailing Address - Street 2:
Mailing Address - City:MASSENA
Mailing Address - State:NY
Mailing Address - Zip Code:13662-3214
Mailing Address - Country:US
Mailing Address - Phone:315-705-6666
Mailing Address - Fax:315-705-6675
Practice Address - Street 1:6100 SAINT LAWRENCE CTR
Practice Address - Street 2:
Practice Address - City:MASSENA
Practice Address - State:NY
Practice Address - Zip Code:13662-3214
Practice Address - Country:US
Practice Address - Phone:315-705-6666
Practice Address - Fax:315-705-6675
Is Sole Proprietor?:No
Enumeration Date:2006-03-25
Last Update Date:2019-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY196213207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
G25611Medicare UPIN