Provider Demographics
NPI:1336539360
Name:LAWRENCE, PRIYA (MS, RD, CDN)
Entity type:Individual
Prefix:
First Name:PRIYA
Middle Name:
Last Name:LAWRENCE
Suffix:
Gender:F
Credentials:MS, RD, CDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 E 22ND ST
Mailing Address - Street 2:16P
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10010-5315
Mailing Address - Country:US
Mailing Address - Phone:212-979-5449
Mailing Address - Fax:
Practice Address - Street 1:5 E 22ND ST
Practice Address - Street 2:16P
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-5315
Practice Address - Country:US
Practice Address - Phone:212-979-5449
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-29
Last Update Date:2015-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY48 006346133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered