MEDICARE: DR. ROY STUART LERNER MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	149569	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	14956960NY	OTHER	NY	1199
2	3302485	OTHER	NY	AETNA
3	GP323	OTHER	NY	OXFORD
4	5074002	OTHER	NY	CIGNA
5	87D57	OTHER	NY	BLUE CROSS
6	0004395	OTHER	NY	GHI
7	0H1647	OTHER	NY	HEALTHNET

General Provider Information

NPI Number	:	1265512735
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROY STUART LERNER MD

Provider Business Mailing Address
First Line	:	6 WARD DR
Second Line	:
City	:	NEW ROCHELLE
State	:	NY
Zip	:	10804-1917
Country	:	US
Telephone Number	:	718-405-8200
Fax Number	:	718-405-8016

Provider Business Practice Location Address
First Line	:	1180 MORRIS PARK AVE
Second Line	:	FIRST FLOOR
City	:	BRONX
State	:	NY
Zip	:	10461-1925
Country	:	US
Telephone Number	:	718-829-1334
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/17/2006
Last Update Date	:	07/08/2007

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