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General NPI Number Information
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NPI Number | 1053640375
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Entity Type | Organization
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Legal Business Name | SCOTT LESSER OD PA
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Dates
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Enumeration Date | 12/15/2009
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Last Update Date | 12/15/2009
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Provider Practice Location Address
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Address Line | 7008 REISTERSTOWN RD
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City | BALTIMORE
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State | MD
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Zip | 21215-1423
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Country | US
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Telephone | 410-764-3366
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Fax |
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Provider Business Mailing Address
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Address Line | 7008 REISTERSTOWN RD
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City | BALTIMORE
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State | MD
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Zip | 21215-1423
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | LESLEY LESSER
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Credential |
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Telephone | 410-764-3366
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | TA1220
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License Number State | MD
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