Basic Information
Provider Information
NPI: 1174576425
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SCHMITT
FirstName: LESTER
MiddleName: G
NamePrefix:  
NameSuffix:  
Credential: C.R.N.A.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 725
Address2:  
City: COOPERSTOWN
State: NY
PostalCode: 133260725
CountryCode: US
TelephoneNumber: 6075473909
FaxNumber: 6075476325
Practice Location
Address1: 1 ATWELL RD
Address2:  
City: COOPERSTOWN
State: NY
PostalCode: 133261301
CountryCode: US
TelephoneNumber: 6075473909
FaxNumber: 6075476325
Other Information
ProviderEnumerationDate: 05/18/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: X
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
367500000X289783NYY Physician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered 

No ID Information.


Home