Provider Demographics
NPI:1114061330
Name:LERNER, JOSEPH (OPTICIAN)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:LERNER
Suffix:
Gender:M
Credentials:OPTICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 WASHINGTON AVE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:PLAINVIEW
Mailing Address - State:NY
Mailing Address - Zip Code:11803-4045
Mailing Address - Country:US
Mailing Address - Phone:516-931-0110
Mailing Address - Fax:516-470-0025
Practice Address - Street 1:10 WASHINGTON AVE
Practice Address - Street 2:SUITE 2
Practice Address - City:PLAINVIEW
Practice Address - State:NY
Practice Address - Zip Code:11803-4045
Practice Address - Country:US
Practice Address - Phone:516-931-0110
Practice Address - Fax:516-470-0025
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-19
Last Update Date:2007-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY5062156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0186160001Medicare NSC