Healthcare Provider Details

I. General information

NPI: 1073540001
Provider Name (Legal Business Name): JOEL MARK LERNER D.P.M.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2006
Last Update Date: 02/02/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 MORRIS AVE STE 304
SPRINGFIELD NJ
07081-1427
US

IV. Provider business mailing address

100 MORRIS AVE STE 304
SPRINGFIELD NJ
07081-1427
US

V. Phone/Fax

Practice location:
  • Phone: 973-258-0111
  • Fax: 973-258-0123
Mailing address:
  • Phone: 973-258-0111
  • Fax: 973-258-0122

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number25MD00171700
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: