Healthcare Provider Details

I. General information

NPI: 1578523254
Provider Name (Legal Business Name): LESTER KATZEL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 03/25/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

444 WHITE SPRUCE BLVD
ROCHESTER NY
14623-1608
US

IV. Provider business mailing address

444 WHITE SPRUCE BLVD
ROCHESTER NY
14623-1608
US

V. Phone/Fax

Practice location:
  • Phone: 585-424-6500
  • Fax: 585-424-6558
Mailing address:
  • Phone: 585-424-6500
  • Fax: 585-424-6558

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080A0000X
TaxonomyPediatric Adolescent Medicine Physician
License Number119548
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: