Provider Demographics
NPI:1154507697
Name:O'SHEA, LAWRENCE ROBERT III
Entity Type:Individual
Prefix:MR
First Name:LAWRENCE
Middle Name:ROBERT
Last Name:O'SHEA
Suffix:III
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:544 OLD NIAGARA RD
Mailing Address - Street 2:
Mailing Address - City:LOCKPORT
Mailing Address - State:NY
Mailing Address - Zip Code:14094-1418
Mailing Address - Country:US
Mailing Address - Phone:716-433-6206
Mailing Address - Fax:
Practice Address - Street 1:51 SAINT JOHNS PARKSIDE ST
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14210-2515
Practice Address - Country:US
Practice Address - Phone:716-828-9560
Practice Address - Fax:716-828-9460
Is Sole Proprietor?:No
Enumeration Date:2008-01-15
Last Update Date:2008-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist