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General NPI Number Information
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NPI Number | 1073916375
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Entity Type | Individual
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Provider Name | LAURENCE JAWORSKI MD
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Gender | Female
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Dates
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Enumeration Date | 09/30/2014
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Last Update Date | 09/30/2014
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Provider Practice Location Address
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Address Line | 10 CENTER DR BG10 RM10N109
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City | BETHESDA
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State | MD
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Zip | 20814
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Country | US
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Telephone | 301-496-3123
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Fax |
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Provider Business Mailing Address
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Address Line | 7707 WISCONSIN AVE APT 1114
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City | BETHESDA
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State | MD
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Zip | 20814-6557
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Country | US
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Telephone | 514-224-8274
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 0101256081
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License Number State | VA
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