Provider Demographics
NPI:1225490477
Name:BRALY, LAWRENCE FRANKLIN (MD)
Entity Type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:FRANKLIN
Last Name:BRALY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:L
Other - Middle Name:FRANKLIN
Other - Last Name:BRALY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:114 HORATIO ST
Mailing Address - Street 2:310
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10014-1574
Mailing Address - Country:US
Mailing Address - Phone:212-255-7801
Mailing Address - Fax:
Practice Address - Street 1:114 HORATIO ST
Practice Address - Street 2:310
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10014-1574
Practice Address - Country:US
Practice Address - Phone:212-255-7801
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-27
Last Update Date:2016-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY145811207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology