Healthcare Provider Details

I. General information

NPI: 1285656926
Provider Name (Legal Business Name): JOSEPH F LAWSON FNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/24/2006
Last Update Date: 05/28/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

293 W NORTH ST
GENEVA NY
14456-1530
US

IV. Provider business mailing address

67 KENDALL ST SUITE 200
CLIFTON SPRINGS NY
14432-9701
US

V. Phone/Fax

Practice location:
  • Phone: 315-789-0993
  • Fax: 315-789-0281
Mailing address:
  • Phone: 315-462-9482
  • Fax: 315-462-5438

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberF330625
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: