Provider Demographics
NPI:1205126976
Name:LESTER, KATHRYN VINER (PSYD)
Entity type:Individual
Prefix:DR
First Name:KATHRYN
Middle Name:VINER
Last Name:LESTER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:DR
Other - First Name:KATHYRN
Other - Middle Name:MARIA
Other - Last Name:VINER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSYD
Mailing Address - Street 1:ONE MEDICAL CENTER BLVD
Mailing Address - Street 2:ACP, SUITE 232
Mailing Address - City:UPLAND
Mailing Address - State:PA
Mailing Address - Zip Code:19013-3902
Mailing Address - Country:US
Mailing Address - Phone:844-464-6387
Mailing Address - Fax:215-239-3037
Practice Address - Street 1:219 N BROAD ST
Practice Address - Street 2:7TH FLOOR
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-1519
Practice Address - Country:US
Practice Address - Phone:844-464-6387
Practice Address - Fax:215-239-3037
Is Sole Proprietor?:No
Enumeration Date:2011-04-14
Last Update Date:2020-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35SI00530900103G00000X
PAPS016970103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
1205126976OtherNPI