Provider Demographics
NPI:1770700361
Name:LERNER, TRICIA ANN (PA)
Entity type:Individual
Prefix:MRS
First Name:TRICIA
Middle Name:ANN
Last Name:LERNER
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:824 E BROAD ST
Mailing Address - Street 2:
Mailing Address - City:WESTFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07090-2020
Mailing Address - Country:US
Mailing Address - Phone:908-654-3566
Mailing Address - Fax:
Practice Address - Street 1:339 HICKS ST
Practice Address - Street 2:DEPARTMENT OF NEUROSURGERY, LICH
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-5509
Practice Address - Country:US
Practice Address - Phone:718-780-1388
Practice Address - Fax:718-780-1409
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY008278363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant