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General NPI Number Information
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NPI Number | 1417050865
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Entity Type | Organization
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Legal Business Name | LAWRENCE SHADEROWFSKY MD PC
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Dates
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Enumeration Date | 09/07/2006
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Last Update Date | 03/31/2008
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Provider Practice Location Address
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Address Line | 35 E 85TH ST
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City | NEW YORK
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State | NY
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Zip | 10028-0954
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Country | US
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Telephone | 212-535-4728
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Fax | 201-944-1250
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Provider Business Mailing Address
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Address Line | 35 EAST 85TH STREET
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City | NEW YORK
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State | NY
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Zip | 10028
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Country | US
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Telephone | 212-535-4728
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Fax | 201-944-1250
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Authorized Official
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Title or Position | MD PC
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Name | LAWRENCE SHADEROWFSKY
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Credential |
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Telephone | 212-535-4728
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 25MA05150100
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 0865171
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License Number State | NY
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