Healthcare Provider Details

I. General information

NPI: 1275069148
Provider Name (Legal Business Name): DR. LESTHIA ISAACS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/11/2017
Last Update Date: 03/26/2020
Certification Date: 03/26/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9750 TRANSIT RD
EAST AMHERST NY
14051-1311
US

IV. Provider business mailing address

9750 TRANSIT RD
EAST AMHERST NY
14051-1311
US

V. Phone/Fax

Practice location:
  • Phone: 716-636-1375
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number022906
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: