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General NPI Number Information
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NPI Number | 1841268802
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Entity Type | Individual
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Provider Name | LAWRENCE BARUCH M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/08/2006
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Last Update Date | 11/20/2024
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Provider Practice Location Address
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Address Line | 451 PARK AVENUE SOUTH, 2ND FLOOR NORTHWELL HEALTH CONCORDE MEDICAL GROUP
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City | NEW YORK
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State | NY
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Zip | 10016-7376
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Country | US
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Telephone | 212-889-5640
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Fax | 212-684-4775
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Provider Business Mailing Address
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Address Line | 111 E 85TH ST 12D
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City | NEW YORK
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State | NY
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Zip | 10028-0958
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Country | US
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Telephone | 917-833-5636
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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 | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 177261
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License Number State | NY
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