Provider Demographics
NPI:1275773962
Name:CELEBRE, LESTER ANNE GO (PT)
Entity Type:Individual
Prefix:MRS
First Name:LESTER ANNE
Middle Name:GO
Last Name:CELEBRE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MS
Other - First Name:LESTER ANNE
Other - Middle Name:GO
Other - Last Name:LEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:111 KENMORE ST
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10312-1400
Mailing Address - Country:US
Mailing Address - Phone:917-379-0334
Mailing Address - Fax:718-966-2483
Practice Address - Street 1:111 KENMORE ST
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10312-1400
Practice Address - Country:US
Practice Address - Phone:917-379-0334
Practice Address - Fax:718-966-2483
Is Sole Proprietor?:No
Enumeration Date:2009-02-20
Last Update Date:2009-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0241512251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics