Provider Demographics
NPI:1609252972
Name:LESTER NEIL FOGELSANGER
Entity type:Organization
Organization Name:LESTER NEIL FOGELSANGER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LESTER
Authorized Official - Middle Name:N
Authorized Official - Last Name:FOGELSANGER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:215-760-4461
Mailing Address - Street 1:303 W LANCASTER AVE
Mailing Address - Street 2:SUITE 2B
Mailing Address - City:WAYNE
Mailing Address - State:PA
Mailing Address - Zip Code:19087-3938
Mailing Address - Country:US
Mailing Address - Phone:215-760-4461
Mailing Address - Fax:678-693-6166
Practice Address - Street 1:303 W LANCASTER AVE
Practice Address - Street 2:SUITE 2B
Practice Address - City:WAYNE
Practice Address - State:PA
Practice Address - Zip Code:19087-3938
Practice Address - Country:US
Practice Address - Phone:215-760-4461
Practice Address - Fax:678-693-6166
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-10
Last Update Date:2015-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD4278362084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty