Basic Information
Provider Information
NPI: 1548339351
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LESTER
FirstName: GEORGINA
MiddleName: I
NamePrefix:  
NameSuffix:  
Credential: M. D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 110 S BEDFORD RD
Address2: CARE MOUNT MEDICAL PC
City: MOUNT KISCO
State: NY
PostalCode: 105493446
CountryCode: US
TelephoneNumber: 9149412129
FaxNumber: 9149411969
Practice Location
Address1: 537 N STATE RD
Address2: CARE MOUNT MEDICAL PC
City: BRIARCLIFF MANOR
State: NY
PostalCode: 105101573
CountryCode: US
TelephoneNumber: 9149412129
FaxNumber: 9149411969
Other Information
ProviderEnumerationDate: 11/07/2006
LastUpdateDate: 11/11/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208000000X136243NYY Allopathic & Osteopathic PhysiciansPediatrics 

ID Information
IDTypeStateIssuerDescription
154833935101NYATLANTIS HEALTH PLANOTHER
154833935101NYCIGNAOTHER
154833935101NYAETNAOTHER
154833935101NYOXFORDOTHER
0081877705NY MEDICAID
154833935101NYUNITED HEALTHCARE / EMPIRE PLANOTHER
154833935101NYMULTIPLANOTHER
154833935101NYUNITED HEALTH CAREOTHER
154833935101NYPHCSOTHER
154833935101NYBLUE CROSS / BLUE SHIELDOTHER
154833935101NYHEALTHNETOTHER
154833935101NYMVPOTHER
154833935101NYPOMCOOTHER


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