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Organization

IRA LEDERMAN MD PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
PAM HOPKINS (BILLING ADMINISTRATOR)
(757) 583-5826
Entity
Organization

Contact information

Practice address
7312 GRANBY ST, NORFOLK, VA 23505-3442
(757) 583-5826
(757) 588-2712
Mailing address
7312 GRANBY ST, NORFOLK, VA 23505-3442
(757) 583-5826
(757) 588-2712

Taxonomy

Speciality
Code
Description
License number
State
156FX1100X
Ophthalmic Technician/Technologist
Primary
0101016600
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
10003994
OPTIMA
01
11392646
CAQH
01
188089
BLUE CROSS PIN#
VA
01
188089
BCBS
01
GROUP DE8392
RAILROAD MEDICARE
01
P00319350
RAILROAD MEDICARE
Enumeration date
01/09/2007
Last updated
04/20/2008
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