1497778161 NPI number — ROBERT G LERNER MD

Table of content: ROBERT G LERNER MD (NPI 1497778161)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1497778161 NPI number — ROBERT G LERNER MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LERNER
Provider First Name:
ROBERT
Provider Middle Name:
G
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1497778161
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/21/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
19 BRADHURST AVE
Provider Second Line Business Mailing Address:
SUITE 3070N
Provider Business Mailing Address City Name:
HAWTHORNE
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10532-2140
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
914-372-7887
Provider Business Mailing Address Fax Number:
914-372-7884

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
19 BRADHURST AVE
Provider Second Line Business Practice Location Address:
SUITE 3070N
Provider Business Practice Location Address City Name:
HAWTHORNE
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10532-2140
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
914-372-7887
Provider Business Practice Location Address Fax Number:
914-372-7884
Provider Enumeration Date:
07/25/2006

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: 207RH0003X , with the licence number:  086808 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 00135424 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 086808 . This is a "HIP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 133277785 . This is a "POMCO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 001076 . This is a "CONNECTICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 113815 . This is a "WELLCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1000016495 . This is a "AFFINITY" identifier . This identifiers is of the category "OTHER".
  • Identifier: 110063277 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: LR8039 . This is a "ATLANTIS" identifier . This identifiers is of the category "OTHER".
  • Identifier: WS727 . This is a "OXFORD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 00000043813 . This is a "GHI HMO" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 0533021 . This is a "AETNA HMO" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 40220770 . This is a "FIDELIS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0005291 . This is a "GHI PPO" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 381615 . This is a "MVP" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 5C9542 . This is a "HEALTHNET" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 4396804 . This is a "AETNA PPO" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 520771 . This is a "BCBS OF NY" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




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