Provider Demographics
NPI:1528024809
Name:JAY LERMAN MD PC
Entity Type:Organization
Organization Name:JAY LERMAN MD PC
Other - Org Name:LERMAN DIAGNOSTIC IMAGING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JAY
Authorized Official - Middle Name:E
Authorized Official - Last Name:LERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-491-4545
Mailing Address - Street 1:6511 FORT HAMILTON PKWY
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11219-5524
Mailing Address - Country:US
Mailing Address - Phone:718-491-4545
Mailing Address - Fax:718-491-4123
Practice Address - Street 1:6511 FORT HAMILTON PKWY
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11219-5524
Practice Address - Country:US
Practice Address - Phone:718-491-4545
Practice Address - Fax:718-491-4123
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-25
Last Update Date:2007-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01441836Medicaid
NY16H771Medicare PIN