Healthcare Provider Details
I. General information
NPI: 1043317233
Provider Name (Legal Business Name): G LEE LERCH & ASSOCIATES, PA
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/20/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
619 LAUREL RD
LAUREL SPRINGS NJ
08021-3029
US
IV. Provider business mailing address
619 LAUREL RD
LAUREL SPRINGS NJ
08021-3029
US
V. Phone/Fax
- Phone: 856-435-6000
- Fax: 856-782-1667
- Phone: 856-435-6000
- Fax: 856-782-1667
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
GORDON
LEE
LERCH
Title or Position: PHYSICIAN
Credential: DO
Phone: 856-435-6000