Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | 25MA074450 | NJ |
N | 207RG0100X | Gastroenterologist | MD424644 | PA |
NPI | 1023096575 |
---|---|
Provider Name | Dr. Gregory Scott Lesser |
First Address | Roselle Park, NJ 07204-2361 |
Second Address | Willingboro, NJ 08046-1104 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/01/2006 |
Last Update Date | 30/12/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1012366560001 | (05) | PA |
I27232 | (02) | PA |