Provider Demographics
NPI:1063169274
Name:LAWSON, PEARL D (DAOM)
Entity type:Individual
Prefix:DR
First Name:PEARL
Middle Name:D
Last Name:LAWSON
Suffix:
Gender:F
Credentials:DAOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:119 PONDFIELD RD UNIT 911
Mailing Address - Street 2:
Mailing Address - City:BRONXVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:10708-7642
Mailing Address - Country:US
Mailing Address - Phone:914-246-2633
Mailing Address - Fax:
Practice Address - Street 1:105 GRAND ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11249-4123
Practice Address - Country:US
Practice Address - Phone:914-246-2633
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-08
Last Update Date:2022-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAKO000666171100000X
WI1040171100000X
NY007072-01171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist