Provider Demographics
NPI:1902089196
Name:LERNER, STEPHEN (PHARMACIST)
Entity Type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:
Last Name:LERNER
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1010 ROSSVILLE AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10309-1715
Mailing Address - Country:US
Mailing Address - Phone:718-356-9292
Mailing Address - Fax:718-967-7338
Practice Address - Street 1:1010 ROSSVILLE AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10309-1715
Practice Address - Country:US
Practice Address - Phone:718-356-9292
Practice Address - Fax:718-967-7338
Is Sole Proprietor?:No
Enumeration Date:2007-12-11
Last Update Date:2007-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY044485183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist