Healthcare Provider Details

I. General information

NPI: 1689771883
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

445 HURFFVILLE CROSSKEYS RD
SEWELL NJ
08080-2337
US

IV. Provider business mailing address

445 HURFFVILLE CROSSKEYS RD
SEWELL NJ
08080-2337
US

V. Phone/Fax

Practice location:
  • Phone: 856-256-7950
  • Fax: 856-256-7954
Mailing address:
  • Phone: 856-256-7950
  • Fax: 856-256-7954

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. GORDON LEE LERCH
Title or Position: PHYSICIAN
Credential: DO
Phone: 856-435-6000