Provider Demographics
NPI:1588819478
Name:KERNER, LISA KAREN (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:LISA
Middle Name:KAREN
Last Name:KERNER
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:MRS
Other - First Name:DENA
Other - Middle Name:LISA
Other - Last Name:KERNER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OTR/L
Mailing Address - Street 1:12 MANCHESTER DR
Mailing Address - Street 2:
Mailing Address - City:SPRING VALLEY
Mailing Address - State:NY
Mailing Address - Zip Code:10977-2013
Mailing Address - Country:US
Mailing Address - Phone:845-354-2902
Mailing Address - Fax:
Practice Address - Street 1:465 VIOLA RD
Practice Address - Street 2:RAMAPO FRESHMAN CENTER
Practice Address - City:SPRING VALLEY
Practice Address - State:NY
Practice Address - Zip Code:10977-2035
Practice Address - Country:US
Practice Address - Phone:845-356-0191
Practice Address - Fax:845-356-0193
Is Sole Proprietor?:No
Enumeration Date:2008-11-19
Last Update Date:2008-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004891-1174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist