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NPI Code Detail

MEDICARE: LAWRENCE S GOLUB DDS

MEDICARE: LAWRENCE S GOLUB DDS
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
11223G0001XGeneral Practice Dentistry030843NY

General Provider Information

NPI Number : 1659459527
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAWRENCE S GOLUB DDS
Provider Business Mailing Address
First Line : 30 PIPER DR
Second Line :
City : ALBERTSON
State : NY
Zip : 11507-1517
Country : US
Telephone Number : 516-248-5786
Fax Number :
Provider Business Practice Location Address
First Line : 15005 UNION TPKE
Second Line :
City : FLUSHING
State : NY
Zip : 11367-3927
Country : US
Telephone Number : 718-380-0444
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/01/2006
Last Update Date : 07/08/2007

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