Provider Demographics
NPI:1598099715
Name:LERMAN, SVETLANA (PHYSICIAN ASSISTANT)
Entity Type:Individual
Prefix:
First Name:SVETLANA
Middle Name:
Last Name:LERMAN
Suffix:
Gender:F
Credentials:PHYSICIAN ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:355 KINGS HWY
Mailing Address - Street 2:5-E
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11223-1579
Mailing Address - Country:US
Mailing Address - Phone:646-346-9001
Mailing Address - Fax:
Practice Address - Street 1:355 KINGS HWY
Practice Address - Street 2:5-E
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11223-1579
Practice Address - Country:US
Practice Address - Phone:646-346-9001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-21
Last Update Date:2009-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013562363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant