Provider Demographics
NPI:1154562387
Name:LESSING, JUDITH L (NPP)
Entity type:Individual
Prefix:MRS
First Name:JUDITH
Middle Name:L
Last Name:LESSING
Suffix:
Gender:F
Credentials:NPP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:633 CLOVE ROAD
Mailing Address - Street 2:#6
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10310
Mailing Address - Country:US
Mailing Address - Phone:917-821-4888
Mailing Address - Fax:718-448-9806
Practice Address - Street 1:633 CLOVE ROAD
Practice Address - Street 2:#6
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10310
Practice Address - Country:US
Practice Address - Phone:917-821-4888
Practice Address - Fax:718-448-9806
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-18
Last Update Date:2016-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY400923363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health