Provider Demographics
NPI:1528165545
Name:LESTER, ANDREW M (PHD)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:M
Last Name:LESTER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:3100 PRINCETON PIKE
Mailing Address - Street 2:BUILDING 3B
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08648-2300
Mailing Address - Country:US
Mailing Address - Phone:609-895-0775
Mailing Address - Fax:609-895-0394
Practice Address - Street 1:3100 PRINCETON PIKE
Practice Address - Street 2:BUILDING 3B
Practice Address - City:LAWRENCEVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08648-2300
Practice Address - Country:US
Practice Address - Phone:609-895-0775
Practice Address - Fax:609-895-0394
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ35S100139500103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ078471Medicare ID - Type Unspecified