Provider Demographics
NPI:1962568311
Name:FRANKEL, LAWRENCE PAUL (OPTICIAN)
Entity type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:PAUL
Last Name:FRANKEL
Suffix:
Gender:M
Credentials:OPTICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1092 RT 112
Mailing Address - Street 2:
Mailing Address - City:PORT JEFFERSON STA
Mailing Address - State:NY
Mailing Address - Zip Code:11776
Mailing Address - Country:US
Mailing Address - Phone:631-474-3937
Mailing Address - Fax:631-474-3966
Practice Address - Street 1:1092 RT 112
Practice Address - Street 2:
Practice Address - City:PORT JEFFERSON STA
Practice Address - State:NY
Practice Address - Zip Code:11776
Practice Address - Country:US
Practice Address - Phone:631-474-3937
Practice Address - Fax:631-474-3966
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY8108-1156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY113014041OtherTAX ID