Provider Demographics
NPI:1891849444
Name:LEHRER, ELLIOTT ALAN (DPM)
Entity Type:Individual
Prefix:
First Name:ELLIOTT
Middle Name:ALAN
Last Name:LEHRER
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:54 PONDEROSA LN
Mailing Address - Street 2:
Mailing Address - City:OLD BRIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:08857-3335
Mailing Address - Country:US
Mailing Address - Phone:732-234-3471
Mailing Address - Fax:609-655-5977
Practice Address - Street 1:190 PROSPECT PLAINS RD
Practice Address - Street 2:
Practice Address - City:MONROE TOWNSHIP
Practice Address - State:NJ
Practice Address - Zip Code:08831-3713
Practice Address - Country:US
Practice Address - Phone:609-655-2222
Practice Address - Fax:609-655-5977
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-22
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MD00138000213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
T44657Medicare UPIN
NJLE77658Medicare ID - Type UnspecifiedMEDICARE NUMBER