Healthcare Provider Details

I. General information

NPI: 1154416113
Provider Name (Legal Business Name): LAWRENCE ANTHONY ZOLNIK M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 01/29/2020
Certification Date: 01/29/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 EASTDALE AVE N
POUGHKEEPSIE NY
12603
US

IV. Provider business mailing address

243 NORTH RD STE 304
POUGHKEEPSIE NY
12601-1173
US

V. Phone/Fax

Practice location:
  • Phone: 845-437-5000
  • Fax:
Mailing address:
  • Phone: 845-437-5000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number144501
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: