Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | 014664 | LA |
Y | 207R00000X | Internist | 014664 | LA |
Y | 111NI0900X | Internist | 014664 | LA |
NPI | 1144221151 |
---|---|
Provider Name | Robert David Lesser |
First Address | River Ridge, LA 70123-2502 |
Second Address | Metairie, LA 70002-1740 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/08/2005 |
Last Update Date | 26/02/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B61858 | (02) |