Provider Demographics
NPI:1316143480
Name:MAAYAN, LAWRENCE (MD)
Entity type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:
Last Name:MAAYAN
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 1:270 GREENWICH AVE
Mailing Address - Street 2:
Mailing Address - City:GREENWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06830-6530
Mailing Address - Country:US
Mailing Address - Phone:203-559-1895
Mailing Address - Fax:
Practice Address - Street 1:1419 SHAKESPEARE AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10452-1851
Practice Address - Country:US
Practice Address - Phone:713-732-7080
Practice Address - Fax:718-732-7090
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-25
Last Update Date:2019-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0405912084P0804X
NY2158122084P0804X
PAMD4664252084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry