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General NPI Number Information
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NPI Number | 1427671304
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Entity Type | Individual
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Provider Name | CHANAN LERER DMD
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Gender | Male
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Dates
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Enumeration Date | 05/26/2020
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Last Update Date | 12/05/2024
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Provider Practice Location Address
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Address Line | 60 FOSTER RD
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City | TENAFLY
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State | NJ
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Zip | 07670
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Country | US
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Telephone | 201-916-6919
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Fax |
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Provider Business Mailing Address
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Address Line | 60 FOSTER RD
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City | TENAFLY
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State | NJ
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Zip | 07670-1955
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Country | US
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Telephone | 201-916-6919
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 22DI02785200
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 22DI02785200
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License Number State | NJ
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