Individual
DR. KENNETH S LERRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
13916 91ST AVE, JAMAICA, NY 11435-4219
(718) 989-5550
(718) 454-8906
Mailing address
13916 91ST AVE, JAMAICA, NY 11435-4219
(718) 989-5550
(718) 454-8906
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
159865
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01049105
—
NY
Enumeration date
04/26/2006
Last updated
02/18/2014
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