Provider Demographics
NPI:1144309030
Name:LESSIG, MARVIN (DO)
Entity type:Individual
Prefix:DR
First Name:MARVIN
Middle Name:
Last Name:LESSIG
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 GRAYROCK RD
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08809-1073
Mailing Address - Country:US
Mailing Address - Phone:908-713-6205
Mailing Address - Fax:732-220-7199
Practice Address - Street 1:167 NEW ST
Practice Address - Street 2:
Practice Address - City:NEW BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08901-1955
Practice Address - Country:US
Practice Address - Phone:732-220-7028
Practice Address - Fax:732-220-7199
Is Sole Proprietor?:No
Enumeration Date:2006-11-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ23312207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology