Provider Demographics
NPI:1154546331
Name:LAWRENCE, ANTHONY OWEN (LAC)
Entity type:Individual
Prefix:MR
First Name:ANTHONY
Middle Name:OWEN
Last Name:LAWRENCE
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
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Mailing Address - Street 1:775 PARK AVE STE 120
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11743-7508
Mailing Address - Country:US
Mailing Address - Phone:631-559-4234
Mailing Address - Fax:516-261-9992
Practice Address - Street 1:775 PARK AVE STE 120
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:NY
Practice Address - Zip Code:11743-7508
Practice Address - Country:US
Practice Address - Phone:631-559-4234
Practice Address - Fax:516-261-9992
Is Sole Proprietor?:No
Enumeration Date:2007-04-14
Last Update Date:2024-09-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY25003088171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1659648673OtherNPI