Provider Demographics
NPI:1316975873
Name:MANION, LAWRENCE M (MD)
Entity type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:M
Last Name:MANION
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:7715 SAND POND RD
Mailing Address - Street 2:
Mailing Address - City:GLENFIELD
Mailing Address - State:NY
Mailing Address - Zip Code:13343-2213
Mailing Address - Country:US
Mailing Address - Phone:315-376-3553
Mailing Address - Fax:
Practice Address - Street 1:214 CHURCH ST
Practice Address - Street 2:
Practice Address - City:CARTHAGE
Practice Address - State:NY
Practice Address - Zip Code:13619-1212
Practice Address - Country:US
Practice Address - Phone:315-493-0128
Practice Address - Fax:315-493-6200
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2013-02-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY147069207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
B82340Medicare UPIN