Healthcare Provider Details

I. General information

NPI: 1033197009
Provider Name (Legal Business Name): PETER LAWRENCE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/09/2006
Last Update Date: 05/15/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44 1ST AVE
OSSINING NY
10562-2622
US

IV. Provider business mailing address

44 1ST AVE
OSSINING NY
10562-2622
US

V. Phone/Fax

Practice location:
  • Phone: 914-923-2323
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number25MA07956800
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: