Provider Demographics
NPI:1104869304
Name:EPSTEIN, LAWRENCE JAY (MD)
Entity type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:JAY
Last Name:EPSTEIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 12023
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07101-5023
Mailing Address - Country:US
Mailing Address - Phone:212-427-2666
Mailing Address - Fax:212-289-6929
Practice Address - Street 1:1 GUSTAVE L LEVY PL
Practice Address - Street 2:ANESTHESIOLOGY - BOX 1010
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-6500
Practice Address - Country:US
Practice Address - Phone:800-627-4470
Practice Address - Fax:412-937-5710
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-14
Last Update Date:2013-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1560691207L00000X, 207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01021154Medicaid
2C3826OtherHEALTHNET
P1295036OtherOXFORD
2C3826OtherHEALTHNET
A60336Medicare UPIN