Provider Demographics
NPI:1083791149
Name:RAISA LERNER MD INC
Entity Type:Organization
Organization Name:RAISA LERNER MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RAISA
Authorized Official - Middle Name:
Authorized Official - Last Name:LERNER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:216-491-4933
Mailing Address - Street 1:1440 ROCKSIDE ROAD
Mailing Address - Street 2:SUITE 215 A
Mailing Address - City:PARMA
Mailing Address - State:OH
Mailing Address - Zip Code:44134
Mailing Address - Country:US
Mailing Address - Phone:216-398-4898
Mailing Address - Fax:216-398-4884
Practice Address - Street 1:1440 ROCKSIDE RD
Practice Address - Street 2:SUITE 215 A
Practice Address - City:PARMA
Practice Address - State:OH
Practice Address - Zip Code:44134-2774
Practice Address - Country:US
Practice Address - Phone:216-398-4898
Practice Address - Fax:216-398-4884
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2008-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35042440207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH9195003Medicare PIN
OH9195001Medicare PIN