Provider Demographics
NPI:1144596735
Name:LAWRENCE B HURWITZ M.D.P.C.
Entity Type:Organization
Organization Name:LAWRENCE B HURWITZ M.D.P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:B
Authorized Official - Last Name:HURWITZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:315-452-2250
Mailing Address - Street 1:5100 W TAFT RD STE 3J
Mailing Address - Street 2:
Mailing Address - City:LIVERPOOL
Mailing Address - State:NY
Mailing Address - Zip Code:13088-3809
Mailing Address - Country:US
Mailing Address - Phone:315-452-2250
Mailing Address - Fax:315-452-2252
Practice Address - Street 1:5100 W TAFT RD STE 3J
Practice Address - Street 2:
Practice Address - City:LIVERPOOL
Practice Address - State:NY
Practice Address - Zip Code:13088-3809
Practice Address - Country:US
Practice Address - Phone:315-452-2250
Practice Address - Fax:315-452-2252
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-28
Last Update Date:2012-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0967692084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYB80012Medicare UPIN