1043483571 NPI number — DR. LESTER DICKINSON MORRIS VMD

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1043483571 NPI number — DR. LESTER DICKINSON MORRIS VMD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MORRIS
Provider First Name:
LESTER
Provider Middle Name:
DICKINSON
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
VMD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MORRIS
Provider Other First Name:
L
Provider Other Middle Name:
DICKINSON
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
VMD
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1043483571
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/04/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 10
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HO HO KUS
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07423-0010
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
201-956-3215
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
205 BROOKSIDE AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HO HO KUS
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07423
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
201-956-3215
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/04/2008

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 174M00000X , with the licence number:  29V100091500 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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