Provider Demographics
NPI:1649535550
Name:BRADLEY-LESTER, ARLENE (MSED)
Entity type:Individual
Prefix:MS
First Name:ARLENE
Middle Name:
Last Name:BRADLEY-LESTER
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:345 E 93RD ST APT 32G
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-5524
Mailing Address - Country:US
Mailing Address - Phone:917-279-0607
Mailing Address - Fax:
Practice Address - Street 1:345 E 93RD ST APT 32G
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-5524
Practice Address - Country:US
Practice Address - Phone:917-279-0607
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-06
Last Update Date:2012-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist