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General NPI Number Information
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NPI Number | 1609252972
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Entity Type | Organization
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Legal Business Name | LESTER NEIL FOGELSANGER
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Dates
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Enumeration Date | 08/10/2015
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Last Update Date | 08/10/2015
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Provider Practice Location Address
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Address Line | 303 W LANCASTER AVE SUITE 2B
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City | WAYNE
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State | PA
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Zip | 19087-3938
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Country | US
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Telephone | 215-760-4461
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Fax | 678-693-6166
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Provider Business Mailing Address
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Address Line | 303 W LANCASTER AVE SUITE 2B
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City | WAYNE
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State | PA
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Zip | 19087-3938
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Country | US
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Telephone | 215-760-4461
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Fax | 678-693-6166
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Authorized Official
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Title or Position | OWNER
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Name | DR. LESTER N FOGELSANGER
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Credential | M.D.
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Telephone | 215-760-4461
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | MD427836
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License Number State | PA
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