Provider Demographics
NPI:1578522454
Name:LERCHE, ADAM
Entity Type:Individual
Prefix:DR
First Name:ADAM
Middle Name:
Last Name:LERCHE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 MALLARD DR
Mailing Address - Street 2:
Mailing Address - City:WEST NYACK
Mailing Address - State:NY
Mailing Address - Zip Code:10994-1006
Mailing Address - Country:US
Mailing Address - Phone:212-304-7250
Mailing Address - Fax:
Practice Address - Street 1:446 ROUTE 304
Practice Address - Street 2:BARDONIA PEDIATRIC ASSOCIATES
Practice Address - City:BARDONIA
Practice Address - State:NY
Practice Address - Zip Code:10954-1617
Practice Address - Country:US
Practice Address - Phone:845-623-8031
Practice Address - Fax:845-624-0928
Is Sole Proprietor?:No
Enumeration Date:2006-03-21
Last Update Date:2013-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1985992080P0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0204XAllopathic & Osteopathic PhysiciansPediatricsPediatric Emergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01728367Medicaid
NY01728367Medicaid