Provider Demographics
NPI:1649213968
Name:LERNER, COREY ELIOT (MD)
Entity Type:Individual
Prefix:DR
First Name:COREY
Middle Name:ELIOT
Last Name:LERNER
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 1:64-20 SAUNDERS ST
Mailing Address - Street 2:
Mailing Address - City:REGO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11374
Mailing Address - Country:US
Mailing Address - Phone:718-897-2363
Mailing Address - Fax:718-897-1961
Practice Address - Street 1:64-20 SAUNDERS ST
Practice Address - Street 2:
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374
Practice Address - Country:US
Practice Address - Phone:718-897-2363
Practice Address - Fax:718-897-1961
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2010-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY129738207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY66A37OtherEMPIRE BCBS
NY03498GMedicare ID - Type Unspecified
B88640Medicare UPIN