Provider Demographics
NPI:1487775151
Name:LERNER, STEFAN (MD)
Entity type:Individual
Prefix:
First Name:STEFAN
Middle Name:
Last Name:LERNER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 NASSAU STREET
Mailing Address - Street 2:SUITE 514
Mailing Address - City:PRINCETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08540-3064
Mailing Address - Country:US
Mailing Address - Phone:609-683-8112
Mailing Address - Fax:609-683-0256
Practice Address - Street 1:20 NASSAU ST
Practice Address - Street 2:SUITE 514
Practice Address - City:PRINCETON
Practice Address - State:NJ
Practice Address - Zip Code:08542-4509
Practice Address - Country:US
Practice Address - Phone:609-683-8112
Practice Address - Fax:609-683-0256
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-02
Last Update Date:2013-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA026666002084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ222131449OtherFEDERAL TAX ID NUMBER
NJ222131449OtherFEDERAL TAX ID NUMBER