Organization
IRA LEDERMAN MD PC
Active
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
Update your record
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