Provider Demographics
NPI:1275538027
Name:LERRO, FUREY ANTHONY (MD)
Entity Type:Individual
Prefix:
First Name:FUREY
Middle Name:ANTHONY
Last Name:LERRO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43 W FRONT ST
Mailing Address - Street 2:STE 22
Mailing Address - City:RED BANK
Mailing Address - State:NJ
Mailing Address - Zip Code:07701-1600
Mailing Address - Country:US
Mailing Address - Phone:732-842-0430
Mailing Address - Fax:732-842-8011
Practice Address - Street 1:43 W FRONT ST
Practice Address - Street 2:STE 22
Practice Address - City:RED BANK
Practice Address - State:NJ
Practice Address - Zip Code:07701-1600
Practice Address - Country:US
Practice Address - Phone:732-842-0430
Practice Address - Fax:732-842-8011
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA025239002084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7033800Medicaid
LE19521Medicare ID - Type UnspecifiedPROVIDER NUMBER
NJ7033800Medicaid