Provider Demographics
NPI:1932209053
Name:LESSER, DONNA (DO)
Entity Type:Individual
Prefix:DR
First Name:DONNA
Middle Name:
Last Name:LESSER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:994 W JERICHO TPKE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:SMITHTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:11787-3235
Mailing Address - Country:US
Mailing Address - Phone:631-864-6111
Mailing Address - Fax:631-486-4498
Practice Address - Street 1:48 ROUTE 25A
Practice Address - Street 2:SUITE 308
Practice Address - City:SMITHTOWN
Practice Address - State:NY
Practice Address - Zip Code:11787-3233
Practice Address - Country:US
Practice Address - Phone:631-864-6111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2018-04-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY00188835207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02154052Medicaid
NY02154052Medicaid
1X9491Medicare ID - Type Unspecified