Provider Demographics
NPI:1255478913
Name:COREY LERNER MD PC
Entity type:Organization
Organization Name:COREY LERNER MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:COREY
Authorized Official - Middle Name:ELIOT
Authorized Official - Last Name:LERNER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-897-2363
Mailing Address - Street 1:6420 SAUNDERS ST
Mailing Address - Street 2:
Mailing Address - City:REGO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11374-3249
Mailing Address - Country:US
Mailing Address - Phone:718-897-2363
Mailing Address - Fax:718-897-1961
Practice Address - Street 1:6420 SAUNDERS ST
Practice Address - Street 2:
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374-3249
Practice Address - Country:US
Practice Address - Phone:718-897-2363
Practice Address - Fax:718-897-1961
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-31
Last Update Date:2010-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03498Medicare ID - Type Unspecified