Healthcare Provider Details

I. General information

NPI: 1316033343
Provider Name (Legal Business Name): HENRY M. LERNER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2006
Last Update Date: 04/26/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 WASHINGTON ST SUITE 768
NEWTON MA
02462-1650
US

IV. Provider business mailing address

2000 WASHINGTON ST SUITE 768
NEWTON MA
02462-1650
US

V. Phone/Fax

Practice location:
  • Phone: 617-332-2345
  • Fax: 617-332-0435
Mailing address:
  • Phone: 617-332-2345
  • Fax: 617-332-0435

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number80472
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: