Basic Information
| Provider Information | |||||||||
| NPI: | 1841382835 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LERA AYOTTE | ||||||||
| FirstName: | LIANA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2966 STREET RD | ||||||||
| Address2: | |||||||||
| City: | BENSALEM | ||||||||
| State: | PA | ||||||||
| PostalCode: | 190202604 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2156380666 | ||||||||
| FaxNumber: | 2156383320 | ||||||||
| Practice Location | |||||||||
| Address1: | 2966 STREET RD | ||||||||
| Address2: | |||||||||
| City: | BENSALEM | ||||||||
| State: | PA | ||||||||
| PostalCode: | 190202604 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2156380666 | ||||||||
| FaxNumber: | 2156383320 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/28/2006 | ||||||||
| LastUpdateDate: | 07/08/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | MD445607 | PA | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 207PE0004X | 240174 | NY | Y | Allopathic & Osteopathic Physicians | Emergency Medicine | Emergency Medical Services |
No ID Information.