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General NPI Number Information
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NPI Number | 1366597395
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Entity Type | Organization
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Legal Business Name | JOSIANE LEDERMAN, MD PC
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Dates
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Enumeration Date | 01/23/2007
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Last Update Date | 08/01/2008
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Provider Practice Location Address
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Address Line | 116 LAMBERTS LN
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City | STATEN ISLAND
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State | NY
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Zip | 10314-7210
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Country | US
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Telephone | 718-370-0422
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Fax | 718-983-6152
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Provider Business Mailing Address
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Address Line | 116 LAMBERTS LN
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City | STATEN ISLAND
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State | NY
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Zip | 10314-7210
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Country | US
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Telephone | 718-370-0422
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Fax | 718-983-6152
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Authorized Official
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Title or Position | OWNER
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Name | DR. JOSIANE LEDERMAN
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Credential | M.D.
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Telephone | 718-370-0422
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 170385
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License Number State | NY
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