MEDICARE: DR. LAWRENCE L FALTZ 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	207RR0500X	Rheumatology Physician	132743	NY

General Provider Information

NPI Number	:	1962492298
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LAWRENCE L FALTZ MD

Provider Business Mailing Address
First Line	:	701 N BROADWAY
Second Line	:
City	:	SLEEPY HOLLOW
State	:	NY
Zip	:	10591-1020
Country	:	US
Telephone Number	:	914-366-1005
Fax Number	:	914-366-1017

Provider Business Practice Location Address
First Line	:	701 N BROADWAY
Second Line	:
City	:	SLEEPY HOLLOW
State	:	NY
Zip	:	10591-1020
Country	:	US
Telephone Number	:	914-366-1005
Fax Number	:	914-366-1017

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

Provider Enumeration Date	:	10/27/2005
Last Update Date	:	07/08/2007

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