MEDICARE: LAWRENCE R BIRZON DC, PT

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	225100000X	Physical Therapist	009221-1	NY
2	111N00000X	Chiropractor	X003059-1	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	00020137801	OTHER	NY	UNIVERA
2	1030314	OTHER	NY	AETNA
3	8803885	OTHER	NY	INDEPENDENT HEALTH
4	000608461004	OTHER	NY	BC BS COMMUNITY BLUE
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	801640	OTHER	NY	EMPIRE PLAN
7	00011191301	OTHER	NY	UNIVERA
8	00208461002	OTHER	NY	BC BS COMMUNITY BLUE

General Provider Information

NPI Number	:	1780690990
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAWRENCE R BIRZON DC, PT

Provider Business Mailing Address
First Line	:	3734 DELAWARE AVE
Second Line	:
City	:	KENMORE
State	:	NY
Zip	:	14217-1002
Country	:	US
Telephone Number	:	716-874-1500
Fax Number	:	716-874-6396

Provider Business Practice Location Address
First Line	:	3734 DELAWARE AVE
Second Line	:
City	:	KENMORE
State	:	NY
Zip	:	14217-1002
Country	:	US
Telephone Number	:	716-874-1500
Fax Number	:	716-874-6396

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

Provider Enumeration Date	:	07/31/2006
Last Update Date	:	04/07/2008

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Directions to “ LAWRENCE R BIRZON DC, PT” Practice Location

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