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NPI Code Detail

MEDICARE: MAX S LAGUERRE, MD PC

MEDICARE: MAX S LAGUERRE, MD PC
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
12085R0001XRadiation Oncology Physician226230 1NY

General Provider Information

NPI Number : 1700879558
Entity Type Code : Organization
Provider Name (Legal Business Name) : MAX S LAGUERRE, MD PC
Provider Business Mailing Address
First Line : 4567 CROSSROADS PARK DR
Second Line : 2ND FLOOR
City : LIVERPOOL
State : NY
Zip : 13088-3589
Country : US
Telephone Number : 315-295-2100
Fax Number : 315-295-2125
Provider Business Practice Location Address
First Line : 5 LYON PL
Second Line :
City : OGDENSBURG
State : NY
Zip : 13669-2586
Country : US
Telephone Number : 315-393-2314
Fax Number : 315-393-3873
Authorized Official
Title or Position : DIRECTOR
Name : DR. MAX S LAGUERRE
Credential : M.D.
Telephone Number : 315-393-2314
Provider Enumeration Date : 08/26/2005
Last Update Date : 08/14/2008

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1366935298 — LINDSEY GRACE MCLEAR NP
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