Provider Demographics
NPI:1962594804
Name:LEHRER, CANDACE (OD)
Entity type:Individual
Prefix:MRS
First Name:CANDACE
Middle Name:
Last Name:LEHRER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:CANDACE
Other - Middle Name:RAE
Other - Last Name:LEHRER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:1634 52ND ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11204-1418
Mailing Address - Country:US
Mailing Address - Phone:718-972-1734
Mailing Address - Fax:718-972-1734
Practice Address - Street 1:3723 NOSTRAND AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-1907
Practice Address - Country:US
Practice Address - Phone:718-646-6200
Practice Address - Fax:718-648-0836
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2010-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005754152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01720052Medicaid
NYU63836Medicare UPIN
NY01720052Medicaid