Healthcare Provider Details

I. General information

NPI: 1184821910
Provider Name (Legal Business Name): KENT S LERNER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2007
Last Update Date: 10/28/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17 JAUNCEY AVENUE
NO ARLINGTON NJ
07031
US

IV. Provider business mailing address

17 JAUNCEY AVENUE
NO ARLINGTON NJ
07031
US

V. Phone/Fax

Practice location:
  • Phone: 201-991-9019
  • Fax: 201-991-0931
Mailing address:
  • Phone: 201-991-9019
  • Fax: 201-991-0931

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberMA36962
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: