Healthcare Provider Details
I. General information
NPI: 1437100682
Provider Name (Legal Business Name): LEDERMAN AND LEDERMAN LLP
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/12/2006
Last Update Date: 04/20/2020
Certification Date: 04/20/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3020 WESTCHESTER AVENUE SUITE 402
PURCHASE NY
10577-2561
US
IV. Provider business mailing address
3020 WESTCHESTER AVENUE SUITE 402
PURCHASE NY
10577-2561
US
V. Phone/Fax
- Phone: 914-417-6441
- Fax: 914-948-2020
- Phone: 914-417-6441
- Fax: 914-948-2020
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207WX0110X |
| Taxonomy | Pediatric Ophthalmology and Strabismus Specialist Physician Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ELISA
ULTO
Title or Position: OFFICE MANAGER
Credential:
Phone: 914-417-6441