Provider Demographics
NPI:1427280288
Name:LESSER, MIRIAM (M ED)
Entity type:Individual
Prefix:
First Name:MIRIAM
Middle Name:
Last Name:LESSER
Suffix:
Gender:F
Credentials:M ED
Other - Prefix:
Other - First Name:MIRIAM
Other - Middle Name:
Other - Last Name:REICHMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:160 AIRPORT RD
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-6927
Mailing Address - Country:US
Mailing Address - Phone:732-367-1888
Mailing Address - Fax:
Practice Address - Street 1:160 AIRPORT RD
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-6927
Practice Address - Country:US
Practice Address - Phone:732-367-1888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-12
Last Update Date:2009-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst