MEDICARE: DR. LAWRENCE STEVEN FORGACS OD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	TUV0032591	NY

General Provider Information

NPI Number	:	1003965427
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LAWRENCE STEVEN FORGACS OD

Provider Business Mailing Address
First Line	:	425 MADISON AVE
Second Line	:	STE 802
City	:	NEW YORK
State	:	NY
Zip	:	10017-1128
Country	:	US
Telephone Number	:	212-583-9000
Fax Number	:	212-755-8479

Provider Business Practice Location Address
First Line	:	425 MADISON AVE
Second Line	:	STE 802
City	:	NEW YORK
State	:	NY
Zip	:	10017-1128
Country	:	US
Telephone Number	:	212-583-9000
Fax Number	:	212-755-8479

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/09/2007
Last Update Date	:	11/21/2013

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