Provider Demographics
NPI:1245306513
Name:MARY LERNA OF HEWLETT INC
Entity type:Organization
Organization Name:MARY LERNA OF HEWLETT INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:LOUIS
Authorized Official - Middle Name:
Authorized Official - Last Name:SEIDEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-569-3150
Mailing Address - Street 1:425 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:CEDARHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11516-1908
Mailing Address - Country:US
Mailing Address - Phone:516-569-3150
Mailing Address - Fax:516-569-3150
Practice Address - Street 1:425 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:CEDARHURST
Practice Address - State:NY
Practice Address - Zip Code:11516-1908
Practice Address - Country:US
Practice Address - Phone:516-569-3150
Practice Address - Fax:516-569-3150
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
0169890001Medicare ID - Type Unspecified