Provider Demographics
NPI:1437100682
Name:LEDERMAN AND LEDERMAN LLP
Entity Type:Organization
Organization Name:LEDERMAN AND LEDERMAN LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ELISA
Authorized Official - Middle Name:
Authorized Official - Last Name:ULTO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:914-417-6441
Mailing Address - Street 1:3020 WESTCHESTER AVENUE
Mailing Address - Street 2:SUITE 402
Mailing Address - City:PURCHASE
Mailing Address - State:NY
Mailing Address - Zip Code:10577-2561
Mailing Address - Country:US
Mailing Address - Phone:914-417-6441
Mailing Address - Fax:914-948-2020
Practice Address - Street 1:3020 WESTCHESTER AVENUE
Practice Address - Street 2:SUITE 402
Practice Address - City:PURCHASE
Practice Address - State:NY
Practice Address - Zip Code:10577-2561
Practice Address - Country:US
Practice Address - Phone:914-417-6441
Practice Address - Fax:914-948-2020
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-12
Last Update Date:2020-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207WX0110XAllopathic & Osteopathic PhysiciansOphthalmologyPediatric Ophthalmology and Strabismus SpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01911682Medicaid
NY01911682Medicaid