Provider Demographics
NPI:1285807628
Name:SIEGEL, LAWRENCE JAY (MD, MPH)
Entity type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:JAY
Last Name:SIEGEL
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:38 E 32ND ST FL 3
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-5568
Mailing Address - Country:US
Mailing Address - Phone:646-962-3940
Mailing Address - Fax:646-952-3357
Practice Address - Street 1:38 E 32ND ST FL 3
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-5568
Practice Address - Country:US
Practice Address - Phone:646-962-3940
Practice Address - Fax:646-952-3357
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-07
Last Update Date:2023-09-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY235928207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine