Provider Demographics
NPI:1316033343
Name:LERNER, HENRY M (MD)
Entity Type:Individual
Prefix:DR
First Name:HENRY
Middle Name:M
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 1:2000 WASHINGTON ST
Mailing Address - Street 2:SUITE 768
Mailing Address - City:NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02462-1650
Mailing Address - Country:US
Mailing Address - Phone:617-332-2345
Mailing Address - Fax:617-332-0435
Practice Address - Street 1:2000 WASHINGTON ST
Practice Address - Street 2:SUITE 768
Practice Address - City:NEWTON
Practice Address - State:MA
Practice Address - Zip Code:02462-1650
Practice Address - Country:US
Practice Address - Phone:617-332-2345
Practice Address - Fax:617-332-0435
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2013-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA80472174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAB76411Medicare ID - Type Unspecified
MAB76411Medicare UPIN