MEDICARE: MR. LAWRENCE IVAN KRING MD

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	207R00000X	Internal Medicine Physician	238150-1	NY
2	208000000X	Pediatrics Physician	238105-1	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P010238150	OTHER	NY	BLUE CROSS BLUE SH
2	1962449025	OTHER	NY	FIDELIS
3	238150	OTHER		LICENSE
4	00041188601	OTHER	NY	BLUE SHIELD OF NENY
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	P000000208907	OTHER	NY	GHI FHP
7	RB1409	OTHER	NY	PALMETTO GBA

General Provider Information

NPI Number	:	1962449025
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. LAWRENCE IVAN KRING MD

Provider Business Mailing Address
First Line	:	50 LEROY ST
Second Line	:
City	:	POTSDAM
State	:	NY
Zip	:	13676-1786
Country	:	US
Telephone Number	:	315-265-3300
Fax Number	:	315-261-6025

Provider Business Practice Location Address
First Line	:	80 E MAIN ST
Second Line	:
City	:	CANTON
State	:	NY
Zip	:	13617-1450
Country	:	US
Telephone Number	:	315-261-5871
Fax Number	:	315-714-3068

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

Provider Enumeration Date	:	05/31/2006
Last Update Date	:	01/24/2018

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