Healthcare Provider Details

I. General information

NPI: 1255474276
Provider Name (Legal Business Name): BETH LERER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/15/2007
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15-2866 GOVERNMENT MAIN ROAD BLDG. E
PAHOA HI
96778
US

IV. Provider business mailing address

PO BOX 863
KEAAU HI
96749-0863
US

V. Phone/Fax

Practice location:
  • Phone: 808-965-2243
  • Fax: 808-965-2245
Mailing address:
  • Phone: 808-965-2243
  • Fax: 808-965-2245

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: