Provider Demographics
NPI:1215930771
Name:CARLTON, LAWRENCE S (DPM)
Entity type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:S
Last Name:CARLTON
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2075 FLATBUSH AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234-3523
Mailing Address - Country:US
Mailing Address - Phone:718-338-8715
Mailing Address - Fax:718-951-8606
Practice Address - Street 1:2075 FLATBUSH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11234-3523
Practice Address - Country:US
Practice Address - Phone:718-338-8715
Practice Address - Fax:718-951-8606
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-27
Last Update Date:2010-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN003542213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY36731POtherHIP
NYLC0P383010OtherEMPIRE BLUE CROSS/ SHIELD
NYP00000007139OtherGHI MEDICARE CHOICE PPO
NYP787695OtherOXFORD HEALTH PLAN
NY480003543OtherMEDICARE RAILROAD
NY2C8013OtherHEALTHNET
NYN003542OtherLICENSE
NY2701510OtherUNITED HEALTHCARE PASSPOR
NYN003542-N01OtherHIP
NY003542-NYOther1199 NATIONAL BENEFIT FUN
NY0606686OtherAETNA US HEALTHCARE
NYN003542-A21OtherHEALTHFIRST
NY0060110OtherGHI
NY137326OtherUNITED HEALTHCARE
NY00820122Medicaid
NY003542-NYOther1199 NATIONAL BENEFIT FUN
NY2C8013OtherHEALTHNET
NYLC0P383010Medicare ID - Type UnspecifiedMEDICARE