Healthcare Provider Details

I. General information

NPI: 1528024809
Provider Name (Legal Business Name): JAY LERMAN MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/25/2006
Last Update Date: 10/12/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6511 FORT HAMILTON PKWY
BROOKLYN NY
11219-5524
US

IV. Provider business mailing address

6511 FORT HAMILTON PKWY
BROOKLYN NY
11219-5524
US

V. Phone/Fax

Practice location:
  • Phone: 718-491-4545
  • Fax: 718-491-4123
Mailing address:
  • Phone: 718-491-4545
  • Fax: 718-491-4123

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. JAY E. LERMAN
Title or Position: MEDICAL DIRECTOR
Credential: M.D.
Phone: 718-491-4545