Basic Information
| Provider Information | |||||||||
| NPI: | 1992747075 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LESTZ | ||||||||
| FirstName: | ELLEN | ||||||||
| MiddleName: | P | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 99 BUSINESS PARK DR | ||||||||
| Address2: | |||||||||
| City: | ARMONK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 105041720 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9148497900 | ||||||||
| FaxNumber: | 9148497995 | ||||||||
| Practice Location | |||||||||
| Address1: | 99 BUSINESS PARK DR | ||||||||
| Address2: | |||||||||
| City: | ARMONK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 105041720 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9148497900 | ||||||||
| FaxNumber: | 9148497995 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/12/2006 | ||||||||
| LastUpdateDate: | 12/17/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2080A0000X | 2136001 | NY | Y | Allopathic & Osteopathic Physicians | Pediatrics | Adolescent Medicine |
No ID Information.