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General NPI Number Information
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NPI Number | 1568523405
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Entity Type | Individual
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Provider Name | LAWRENCE OSLER OD
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Gender | Male
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Dates
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Enumeration Date | 12/13/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2501 MOUNT HOLLY RD # I295
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City | BURLINGTON
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State | NJ
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Zip | 08016-4802
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Country | US
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Telephone | 609-387-3565
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Fax | 609-387-3565
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Provider Business Mailing Address
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Address Line | 852 MONMOUTH ST
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City | GLOUCESTER CITY
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State | NJ
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Zip | 08030-1514
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Country | US
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Telephone | 609-217-3980
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 27T000034100
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License Number State | NJ
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