Provider Demographics
NPI:1598750002
Name:LERNER, ARLENE KAGLE (PHD)
Entity Type:Individual
Prefix:DR
First Name:ARLENE
Middle Name:KAGLE
Last Name:LERNER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:ARLENE
Other - Middle Name:
Other - Last Name:KAGLE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:156 OHLAND RD
Mailing Address - Street 2:
Mailing Address - City:STANFORDVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12581-5604
Mailing Address - Country:US
Mailing Address - Phone:845-868-7005
Mailing Address - Fax:
Practice Address - Street 1:639 WEST END AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025
Practice Address - Country:US
Practice Address - Phone:212-724-6394
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-12
Last Update Date:2011-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY05363103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA300025165OtherPTAN