Healthcare Provider Details

I. General information

NPI: 1891849444
Provider Name (Legal Business Name): ELLIOTT ALAN LEHRER DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/22/2007
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

190 PROSPECT PLAINS RD
MONROE TOWNSHIP NJ
08831-3713
US

IV. Provider business mailing address

54 PONDEROSA LN
OLD BRIDGE NJ
08857-3335
US

V. Phone/Fax

Practice location:
  • Phone: 609-655-2222
  • Fax: 609-655-5977
Mailing address:
  • Phone: 732-234-3471
  • Fax: 609-655-5977

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number25MD00138000
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: