Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | OS018860 | PA |
N | 111NI0900X | Internist | OS018860 | PA |
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | OS018860 | PA |
NPI | 1073920930 |
---|---|
Provider Name | Kimberly K Lessard |
First Address | Willow Grove, PA 19090-1225 |
Second Address | Horsham, PA 19044-2242 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/07/2014 |
Last Update Date | 26/05/2020 |