Provider Demographics
NPI:1639384928
Name:LEHNER, GEORGE JACK (MD)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:JACK
Last Name:LEHNER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:735 MIDDLE COUNTRY RD
Mailing Address - Street 2:
Mailing Address - City:SAINT JAMES
Mailing Address - State:NY
Mailing Address - Zip Code:11780-3211
Mailing Address - Country:US
Mailing Address - Phone:631-656-9200
Mailing Address - Fax:631-656-9203
Practice Address - Street 1:735 MIDDLE COUNTRY RD
Practice Address - Street 2:
Practice Address - City:SAINT JAMES
Practice Address - State:NY
Practice Address - Zip Code:11780-3211
Practice Address - Country:US
Practice Address - Phone:631-656-9200
Practice Address - Fax:631-656-9203
Is Sole Proprietor?:No
Enumeration Date:2007-05-11
Last Update Date:2012-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2425161207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine