MEDICARE: LAWRENCE FORUR O.D.

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	TUV004284	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1023081247
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAWRENCE FORUR O.D.

Provider Business Mailing Address
First Line	:	150 ISLIP AVE
Second Line	:
City	:	ISLIP
State	:	NY
Zip	:	11751-3222
Country	:	US
Telephone Number	:	631-491-6248
Fax Number	:	631-581-7512

Provider Business Practice Location Address
First Line	:	150 ISLIP AVE
Second Line	:	SUITE 12
City	:	ISLIP
State	:	NY
Zip	:	11751-3222
Country	:	US
Telephone Number	:	631-581-5100
Fax Number	:	631-581-7512

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

Provider Enumeration Date	:	02/08/2006
Last Update Date	:	02/14/2012

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Directions to “ LAWRENCE FORUR O.D.” Practice Location

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