Individual
JEREMY LESTCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
630 W 168TH ST, NEW YORK, NY 10032-3725
(212) 305-2500
Mailing address
630 W 168TH ST, NEW YORK, NY 10032-3725
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
F432128-01
NY
Other
Enumeration date
09/01/2021
Last updated
09/01/2021
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