Provider Demographics
NPI:1790834026
Name:LEHR, IRIS (RPT)
Entity Type:Individual
Prefix:
First Name:IRIS
Middle Name:
Last Name:LEHR
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:222 CEDAR LANE
Mailing Address - Street 2:SUITE 120
Mailing Address - City:TEANECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07666
Mailing Address - Country:US
Mailing Address - Phone:201-836-5332
Mailing Address - Fax:201-836-4002
Practice Address - Street 1:222 CEDAR LANE
Practice Address - Street 2:SUITE 120
Practice Address - City:TEANECK
Practice Address - State:NJ
Practice Address - Zip Code:07666
Practice Address - Country:US
Practice Address - Phone:201-836-5332
Practice Address - Fax:201-836-4002
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2017-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00527700225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ22-1958585OtherTAX ID
NJ1144406521OtherNPI