Provider Demographics
NPI:1710901186
Name:LERNER, BARRY MARC (OD DOCTOR OF OPTOMET)
Entity Type:Individual
Prefix:DR
First Name:BARRY
Middle Name:MARC
Last Name:LERNER
Suffix:
Gender:M
Credentials:OD DOCTOR OF OPTOMET
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2443 PLAINFIELD AVENUE
Mailing Address - Street 2:
Mailing Address - City:SOUTH PLAINFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07080
Mailing Address - Country:US
Mailing Address - Phone:908-755-9318
Mailing Address - Fax:908-755-9997
Practice Address - Street 1:2443 PLAINFIELD AVENUE
Practice Address - Street 2:
Practice Address - City:SOUTH PLAINFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07080
Practice Address - Country:US
Practice Address - Phone:908-755-9318
Practice Address - Fax:908-755-9997
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJNJ2960152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0308609Medicaid
310947OtherNVA
07618OtherSPECTERA
LE521167Medicare ID - Type Unspecified