MEDICARE: LAURENCE G BILSKY MD

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	207RH0003X	Hematology & Oncology Physician	112386	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	:	1790766624
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAURENCE G BILSKY MD

Provider Business Mailing Address
First Line	:	40 CROSSWAYS PARK DRIVE
Second Line	:	SUITE 103
City	:	WOODBURY
State	:	NY
Zip	:	11797-2036
Country	:	US
Telephone Number	:	516-921-5533
Fax Number	:	516-364-4080

Provider Business Practice Location Address
First Line	:	40 CROSSWAYS PARK DRIVE
Second Line	:	SUITE 103
City	:	WOODBURY
State	:	NY
Zip	:	11797-2036
Country	:	US
Telephone Number	:	516-921-5533
Fax Number	:	516-364-4080

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

Provider Enumeration Date	:	11/08/2005
Last Update Date	:	07/24/2007

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