1508978396 NPI number — MRS. CATALINA LUCERO LEHRER PA-C

Table of content: MRS. CATALINA LUCERO LEHRER PA-C (NPI 1508978396)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1508978396 NPI number — MRS. CATALINA LUCERO LEHRER PA-C

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LEHRER
Provider First Name:
CATALINA
Provider Middle Name:
LUCERO
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
PA-C
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
BARAN
Provider Other First Name:
CATALINA
Provider Other Middle Name:
LUCERO
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
ATC
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1508978396
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/13/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1306 CONCOURSE DR STE 201
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LINTHICUM HEIGHTS
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21090-1033
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
180 ADMIRAL COCHRANE DR STE 410&420
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ANNAPOLIS
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21401-7300
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
443-351-3376
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/31/2006

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: 363A00000X , with the licence number:  C0004610 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2024 www.npivalidator.com