MEDICARE: DR. CHARLES J LESH JR. MD

Medicare Provider Information

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0202X	Diagnostic Radiology Physician	238925	NY

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
8	P00356171	OTHER		RR MEDICARE

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	00027665602	OTHER		UNIVERA
2	197595FF	OTHER		PREFERRED CARE
3	0121136	OTHER		GHI
4	000528627001	OTHER		BLUE SHIELD WNY
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	1613651	OTHER		INDEPENDENT HEALTH
7	000528627005	OTHER		BLUE SHIELD WNY
9	00027665601	OTHER		UNIVERA
10	2389252W	OTHER	NY	WORKERS COMPENSATION
11	P010238925	OTHER		BLUE CHOICE
12	P020238925	OTHER		BLUE SHIELD ROCHESTER

NPI Number	:	1184670143
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHARLES J LESH JR. MD

Provider Business Mailing Address
First Line	:	PO BOX 8000 DEPT 570
Second Line	:
City	:	BUFFALO
State	:	NY
Zip	:	14267-0002
Country	:	US
Telephone Number	:	716-535-0741
Fax Number	:	716-650-5745

Provider Business Practice Location Address
First Line	:	5300 MILITARY RD
Second Line	:
City	:	LEWISTON
State	:	NY
Zip	:	14092-1903
Country	:	US
Telephone Number	:	716-298-2356
Fax Number	:	716-298-2099

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/25/2006
Last Update Date	:	09/16/2021

5300 MILITARY RD , XRAY DEPT
LEWISTON, NY
14092-1903

Practice Phone: 716-298-2356
Practice Fax: