Provider Demographics
NPI:1275681454
Name:TANCREDI, LAURENCE R (MD)
Entity Type:Individual
Prefix:DR
First Name:LAURENCE
Middle Name:R
Last Name:TANCREDI
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:22 RIVERSIDE DR
Mailing Address - Street 2:APT. 14-A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-1603
Mailing Address - Country:US
Mailing Address - Phone:212-724-6217
Mailing Address - Fax:212-877-6755
Practice Address - Street 1:129B E 71ST ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-4201
Practice Address - Country:US
Practice Address - Phone:212-288-5197
Practice Address - Fax:212-877-6755
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-06
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
NY1329232084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry