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General NPI Number Information
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NPI Number | 1013094523
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Entity Type | Organization
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Legal Business Name | LAWRENCE R ROSENZWEIG DDS PC
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Dates
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Enumeration Date | 11/01/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3305 JERUSALEM AVENUE SUITE 102
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City | WANTAGH
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State | NY
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Zip | 11793
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Country | US
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Telephone | 516-679-5959
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Fax |
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Provider Business Mailing Address
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Address Line | 3305 JERUSALEM AVENUE SUITE 102
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City | WANTAGH
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State | NY
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Zip | 11793
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Country | US
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Telephone | 516-679-5959
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. LAWRENCE ROBERT ROSENZWEIG
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Credential | DDS
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Telephone | 516-679-5959
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 037844
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License Number State | NY
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