Provider Demographics
NPI:1023612967
Name:LERNER, DINA MARIE (RPH)
Entity type:Individual
Prefix:
First Name:DINA
Middle Name:MARIE
Last Name:LERNER
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 1:1187 MAIN ST # 58
Mailing Address - Street 2:
Mailing Address - City:WYOMING
Mailing Address - State:RI
Mailing Address - Zip Code:02898-1074
Mailing Address - Country:US
Mailing Address - Phone:401-539-4000
Mailing Address - Fax:401-539-2750
Practice Address - Street 1:1187 MAIN ST # 58
Practice Address - Street 2:
Practice Address - City:WYOMING
Practice Address - State:RI
Practice Address - Zip Code:02898-1074
Practice Address - Country:US
Practice Address - Phone:401-539-4000
Practice Address - Fax:401-539-2750
Is Sole Proprietor?:No
Enumeration Date:2020-11-22
Last Update Date:2020-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIL3307183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist