Lynna M Lesko, MD, PHD

Individual provider Active NPI Psychiatry Physician · South Kent, CT

NPI 1124383252 · NPPES record last updated Jul 4, 2012

Key facts

NPI
1124383252
Entity type
Individual (NPI type 1)
Primary specialty
Psychiatry Physician 2084P0800X
License
042541 (CT)
Practice address
104 Richards Rd
South Kent, CT 06785-1304
Phone
(860) 927-3370
NPI assigned
Jul 4, 2012
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Doctor of Medicine, Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
G41667CAMDPsychiatry Physician
042541CTMDPsychiatry Physician
152727NYMDPsychiatry Physician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 042541 CT Yes
Psychiatry Physician 2084P0800X G41667 CA
Psychiatry Physician 2084P0800X 152727 NY
Pain Medicine (Psychiatry & Neurology) Physician 2084P2900X 042541 CT

Addresses

Primary practice location

104 Richards Rd
South Kent, CT 06785-1304

Mailing address

104 Richards Rd
South Kent, CT 06785-1304
Phone (860) 927-3370

Other providers in South Kent, CT

All providers in South Kent, CT · Psychiatry Physician in Connecticut

Sources for this page

Verify at the official NPI Registry.