Provider Demographics
NPI:1053375378
Name:LESTER, PAULA (MD,)
Entity type:Individual
Prefix:DR
First Name:PAULA
Middle Name:
Last Name:LESTER
Suffix:
Gender:F
Credentials:MD,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:222 STATION PLZ N
Mailing Address - Street 2:SUITE 518
Mailing Address - City:MINEOLA
Mailing Address - State:NY
Mailing Address - Zip Code:11501-3808
Mailing Address - Country:US
Mailing Address - Phone:516-663-2588
Mailing Address - Fax:516-663-4644
Practice Address - Street 1:222 STATION PLZ N
Practice Address - Street 2:SUITE 518
Practice Address - City:MINEOLA
Practice Address - State:NY
Practice Address - Zip Code:11501-3808
Practice Address - Country:US
Practice Address - Phone:516-663-2588
Practice Address - Fax:516-663-4644
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-13
Last Update Date:2021-02-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY230832207R00000X, 207RH0002X, 207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02677618Medicaid
NYI42511Medicare UPIN
NY0457V2Medicare ID - Type Unspecified