MEDICARE: DR. LAURENCE R. SAUL 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
1	103TP0814X	Psychoanalysis Psychologist	194550	NY

General Provider Information

NPI Number	:	1821146515
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LAURENCE R. SAUL M.D.

Provider Business Mailing Address
First Line	:	291 BROADWAY, SUITE 1505
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10007-1861
Country	:	US
Telephone Number	:	212-327-0753
Fax Number	:	646-253-1267

Provider Business Practice Location Address
First Line	:	291 BROADWAY, SUITE 1505
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10007-1861
Country	:	US
Telephone Number	:	212-327-0753
Fax Number	:	646-253-1267

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

Provider Enumeration Date	:	01/08/2007
Last Update Date	:	06/12/2020

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