Basic Information
Provider Information
NPI: 1083753594
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LEHRER
FirstName: IRA
MiddleName: SETH
NamePrefix: DR.
NameSuffix:  
Credential: DO
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3998 FAIR RIDGE DR
Address2: STE 300
City: FAIRFAX
State: VA
PostalCode: 220332921
CountryCode: US
TelephoneNumber: 7032939590
FaxNumber: 7037669725
Practice Location
Address1: 789 CENTRAL AVE
Address2:  
City: DOVER
State: NH
PostalCode: 038202526
CountryCode: US
TelephoneNumber: 6037497246
FaxNumber: 6037492453
Other Information
ProviderEnumerationDate: 02/05/2007
LastUpdateDate: 04/09/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000X14385NHY Allopathic & Osteopathic PhysiciansAnesthesiology 

No ID Information.


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