Provider Demographics
NPI:1699744219
Name:SHEREN, LORNE (MD)
Entity type:Individual
Prefix:DR
First Name:LORNE
Middle Name:
Last Name:SHEREN
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:PO BOX 404
Mailing Address - Street 2:
Mailing Address - City:NEW VERNON
Mailing Address - State:NJ
Mailing Address - Zip Code:07976-0404
Mailing Address - Country:US
Mailing Address - Phone:908-295-8106
Mailing Address - Fax:304-534-8651
Practice Address - Street 1:1 MILLER RD
Practice Address - Street 2:
Practice Address - City:NEW VERNON
Practice Address - State:NJ
Practice Address - Zip Code:07976-0404
Practice Address - Country:US
Practice Address - Phone:973-714-6777
Practice Address - Fax:973-377-9754
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-16
Last Update Date:2013-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA38513207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
073305Medicare ID - Type Unspecified
D066730Medicare UPIN
D06730Medicare UPIN