Provider Demographics
NPI:1992085278
Name:PACERNICK, LAWRENCE JAY (MD)
Entity type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:JAY
Last Name:PACERNICK
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 1:14 DEER RUN
Mailing Address - Street 2:
Mailing Address - City:OTIS
Mailing Address - State:MA
Mailing Address - Zip Code:01253
Mailing Address - Country:US
Mailing Address - Phone:413-269-7389
Mailing Address - Fax:413-269-7389
Practice Address - Street 1:14 DEER RUN
Practice Address - Street 2:
Practice Address - City:OTIS
Practice Address - State:MA
Practice Address - Zip Code:01253
Practice Address - Country:US
Practice Address - Phone:413-269-7389
Practice Address - Fax:413-269-7389
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-18
Last Update Date:2011-08-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY115544207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology