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NPI Code Detail

MEDICARE: GARY NEVIL LERNER MD

MEDICARE: GARY NEVIL 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
1207R00000XInternal Medicine Physician143344NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1B88783OTHERNYUPIN

General Provider Information

NPI Number : 1538245626
Entity Type Code : Individual
Provider Name (Legal Business Name) : GARY NEVIL LERNER MD
Provider Business Mailing Address
First Line : 6915 YELLOWSTONE BLVD
Second Line :
City : FOREST HILLS
State : NY
Zip : 11375-3753
Country : US
Telephone Number : 718-268-4500
Fax Number : 718-268-1336
Provider Business Practice Location Address
First Line : 6915 YELLOWSTONE BLVD
Second Line :
City : FOREST HILLS
State : NY
Zip : 11375-3753
Country : US
Telephone Number : 718-268-4500
Fax Number : 718-268-1336
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/31/2006
Last Update Date : 09/12/2009

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