MEDICARE: LAWRENCE ABOUSEIF

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	DS-031182-L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1508007212
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAWRENCE ABOUSEIF

Provider Business Mailing Address
First Line	:	2942 SAINT LAWRENCE AVE
Second Line	:
City	:	READING
State	:	PA
Zip	:	19606-2233
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2942 SAINT LAWRENCE AVE
Second Line	:
City	:	READING
State	:	PA
Zip	:	19606-2233
Country	:	US
Telephone Number	:	610-451-4466
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/11/2009
Last Update Date	:	03/11/2009

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