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General NPI Number Information
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NPI Number | 1639669997
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Entity Type | Individual
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Provider Name | LAWRENCE RANDOLPH BELCHER III MD
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Gender | Male
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Dates
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Enumeration Date | 05/12/2018
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Last Update Date | 04/25/2023
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Provider Practice Location Address
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Address Line | 1216 BROADWAY FLOOR 2 PMB 1007
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City | NEW YORK
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State | NY
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Zip | 10001
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Country | US
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Telephone | 617-356-8039
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Fax | 818-477-4659
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Provider Business Mailing Address
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Address Line | 1216 BROADWAY FLOOR 2 PMB 1007
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City | NEW YORK
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State | NY
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Zip | 10001
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Country | US
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Telephone | 617-356-8039
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Fax | 818-477-4659
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 285681
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License Number State | MA
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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 | 35.143336
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 312800
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License Number State | NY
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