Healthcare Provider Details

I. General information

NPI: 1912077124
Provider Name (Legal Business Name): IRIS K LESSER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/08/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

FISHER LANDAU CENTER 1165 MORRIS PARK AVE
BRONX NY
10461
US

IV. Provider business mailing address

3 RICHFIELD ST
PLAINVIEW NY
11803-2246
US

V. Phone/Fax

Practice location:
  • Phone: 718-430-3922
  • Fax:
Mailing address:
  • Phone: 718-430-3922
  • Fax: 718-430-3989

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number153241
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: