Provider Demographics
NPI:1275575466
Name:ATTIA, A. LAWRENCE (MD)
Entity Type:Individual
Prefix:DR
First Name:A. LAWRENCE
Middle Name:
Last Name:ATTIA
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 1:350 W 58TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019-1804
Mailing Address - Country:US
Mailing Address - Phone:212-262-7873
Mailing Address - Fax:212-765-4712
Practice Address - Street 1:350 W 58TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-1804
Practice Address - Country:US
Practice Address - Phone:212-262-7873
Practice Address - Fax:212-765-4712
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-12
Last Update Date:2011-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY189270207R00000X, 207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01598741Medicaid
NY68H703Medicare ID - Type Unspecified
NYF58866Medicare UPIN