Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0207X | Pediatric Hematology-Oncologist | MD428596 | PA |
NPI | 1003009523 |
---|---|
Provider Name | Brian Lestini |
First Address | Philadelphia, PA 19104-3309 |
Second Address | Philadelphia, PA 19104-4399 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/08/2007 |
Last Update Date | 20/08/2007 |