Provider Demographics
NPI:1295042117
Name:LERNER, DANIEL JEREMY (MD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:JEREMY
Last Name:LERNER
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 1:223 MADISON RD
Mailing Address - Street 2:
Mailing Address - City:SCARSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10583-6405
Mailing Address - Country:US
Mailing Address - Phone:415-637-1636
Mailing Address - Fax:
Practice Address - Street 1:223 MADISON RD
Practice Address - Street 2:
Practice Address - City:SCARSDALE
Practice Address - State:NY
Practice Address - Zip Code:10583-6405
Practice Address - Country:US
Practice Address - Phone:415-637-1636
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-13
Last Update Date:2010-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY221154-1207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYF31712Medicare UPIN