Provider Demographics
NPI:1962040451
Name:LESTER, THOMAS ELLIOTT III (PHARMACIST)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:ELLIOTT
Last Name:LESTER
Suffix:III
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:627 ALBANY ST
Mailing Address - Street 2:
Mailing Address - City:LITTLE FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:13365-1503
Mailing Address - Country:US
Mailing Address - Phone:267-738-3127
Mailing Address - Fax:
Practice Address - Street 1:329 S KINGSBORO AVE
Practice Address - Street 2:
Practice Address - City:GLOVERSVILLE
Practice Address - State:NY
Practice Address - Zip Code:12078-4611
Practice Address - Country:US
Practice Address - Phone:518-725-2403
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-15
Last Update Date:2019-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY066378183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist