Healthcare Provider Details

I. General information

NPI: 1265512735
Provider Name (Legal Business Name): ROY STUART LERNER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/17/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1180 MORRIS PARK AVE FIRST FLOOR
BRONX NY
10461-1925
US

IV. Provider business mailing address

6 WARD DR
NEW ROCHELLE NY
10804-1917
US

V. Phone/Fax

Practice location:
  • Phone: 718-829-1334
  • Fax:
Mailing address:
  • Phone: 718-405-8200
  • Fax: 718-405-8016

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number149569
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: