Provider Demographics
NPI:1679805071
Name:LEDERMAN, PAULA S (RPH)
Entity type:Individual
Prefix:MRS
First Name:PAULA
Middle Name:S
Last Name:LEDERMAN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24946 HORACE HARDING EXPY
Mailing Address - Street 2:
Mailing Address - City:DOUGLASTON
Mailing Address - State:NY
Mailing Address - Zip Code:11362-2050
Mailing Address - Country:US
Mailing Address - Phone:718-747-0180
Mailing Address - Fax:
Practice Address - Street 1:24946 HORACE HARDING EXPY
Practice Address - Street 2:
Practice Address - City:DOUGLASTON
Practice Address - State:NY
Practice Address - Zip Code:11362-2050
Practice Address - Country:US
Practice Address - Phone:718-747-0180
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-10
Last Update Date:2010-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY031815183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist