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NPI Code Detail

MEDICARE: DR. LAWRENCE D. CAMPBELL M.D.

MEDICARE: DR. LAWRENCE D. CAMPBELL M.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
1207R00000XInternal Medicine Physician166249-1NY
2207R00000XInternal Medicine Physician042.0013988VT

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
14C4541OTHERNYPHS / HEALTHNET
2AA4619SOTHERNYMDNY
3CP498OTHERNYOXFORD
4000AN2OTHERNYEMPIRE BCBS
5MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6166249POTHERNYHEALTHCARE PARTNERS HIP
70000044342306OTHERNYUNITED HEALTHCARE
835856OTHERNYVYTRA
96077DOTHERNYMAGNACARE
10131673OTHERNYONE HEALTH
11433152NOTHERNYCIGNA

General Provider Information

NPI Number : 1073516191
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LAWRENCE D. CAMPBELL M.D.
Provider Business Mailing Address
First Line : 32 E MAIN ST
Second Line :
City : BAY SHORE
State : NY
Zip : 11706-8301
Country : US
Telephone Number : 631-969-9600
Fax Number : 631-968-7624
Provider Business Practice Location Address
First Line : 32 E MAIN ST
Second Line :
City : BAY SHORE
State : NY
Zip : 11706-8301
Country : US
Telephone Number : 631-969-9600
Fax Number : 631-968-7624
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/23/2005
Last Update Date : 07/05/2019

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