Provider Demographics
NPI:1922391333
Name:LERMAN, DAVID (PSYD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:
Last Name:LERMAN
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:64 BOONE ST
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10314-5004
Mailing Address - Country:US
Mailing Address - Phone:917-783-5378
Mailing Address - Fax:718-761-3156
Practice Address - Street 1:27 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10314-5042
Practice Address - Country:US
Practice Address - Phone:917-783-5378
Practice Address - Fax:718-761-3156
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-17
Last Update Date:2011-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017121-1103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist