Provider Demographics
NPI:1265100770
Name:LERMAN, MICHELLE (MS, ED)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:LERMAN
Suffix:
Gender:F
Credentials:MS, ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:53 CANNONADE DR
Mailing Address - Street 2:
Mailing Address - City:MARLBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:07746-1938
Mailing Address - Country:US
Mailing Address - Phone:646-643-7810
Mailing Address - Fax:
Practice Address - Street 1:53 CANNONADE DR
Practice Address - Street 2:
Practice Address - City:MARLBORO
Practice Address - State:NJ
Practice Address - Zip Code:07746-1938
Practice Address - Country:US
Practice Address - Phone:646-643-7810
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-31
Last Update Date:2021-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist