Provider Demographics
NPI:1447334172
Name:LERMA, PAULINE (MD)
Entity type:Individual
Prefix:
First Name:PAULINE
Middle Name:
Last Name:LERMA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2575 KLOCKNER RD
Mailing Address - Street 2:THE CANCER INSTITUTE OF NJ HAMILTON/RWJUH-HAMILTON
Mailing Address - City:HAMILTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08690
Mailing Address - Country:US
Mailing Address - Phone:609-631-6960
Mailing Address - Fax:609-631-6888
Practice Address - Street 1:2575 KLOCKNER RD
Practice Address - Street 2:THE CANCER INSTITUTE OF NJ HAMILTON/RWJUH-HAMILTON
Practice Address - City:HAMILTON
Practice Address - State:NJ
Practice Address - Zip Code:08690
Practice Address - Country:US
Practice Address - Phone:609-631-6960
Practice Address - Fax:609-631-6888
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2010-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07747100207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ9079807Medicaid
NJ9079807Medicaid
NJ085169XC6Medicare UPIN
NJ085169AHEMedicare PIN