MEDICARE: DR. ROBERT J LEHRER OD

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	152W00000X	Optometrist	VUT0038911	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1578662524
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT J LEHRER OD

Provider Business Mailing Address
First Line	:	30 CANAL STREET
Second Line	:
City	:	PORT JERVIS
State	:	NY
Zip	:	12771-1638
Country	:	US
Telephone Number	:	845-856-1023
Fax Number	:	845-856-0429

Provider Business Practice Location Address
First Line	:	30 CANAL STREET
Second Line	:
City	:	PORT JERVIS
State	:	NY
Zip	:	12771-1638
Country	:	US
Telephone Number	:	845-856-1023
Fax Number	:	845-856-0429

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

Provider Enumeration Date	:	09/22/2006
Last Update Date	:	02/19/2008

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