Provider Demographics
NPI:1285656926
Name:LAWSON, JOSEPH F (FNP)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:F
Last Name:LAWSON
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:67 KENDALL ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CLIFTON SPRINGS
Mailing Address - State:NY
Mailing Address - Zip Code:14432-9701
Mailing Address - Country:US
Mailing Address - Phone:315-462-9482
Mailing Address - Fax:315-462-5438
Practice Address - Street 1:293 W NORTH ST
Practice Address - Street 2:
Practice Address - City:GENEVA
Practice Address - State:NY
Practice Address - Zip Code:14456-1530
Practice Address - Country:US
Practice Address - Phone:315-789-0993
Practice Address - Fax:315-789-0281
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2013-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF330625363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02443992Medicaid
NYCC4283Medicare PIN
NY02443992Medicaid