Provider Demographics
NPI:1194889378
Name:LESSER, MAURY A (PHD)
Entity type:Individual
Prefix:DR
First Name:MAURY
Middle Name:A
Last Name:LESSER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:146 NEW YORK AVE
Mailing Address - Street 2:
Mailing Address - City:DUMONT
Mailing Address - State:NJ
Mailing Address - Zip Code:07628-2512
Mailing Address - Country:US
Mailing Address - Phone:201-385-0081
Mailing Address - Fax:201-385-2996
Practice Address - Street 1:75 N MAPLE AVE
Practice Address - Street 2:
Practice Address - City:RIDGEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07450-3247
Practice Address - Country:US
Practice Address - Phone:201-370-1240
Practice Address - Fax:201-385-2996
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35S100356900103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist