Provider Demographics
NPI:1326136755
Name:HORL, LAWRENCE P
Entity Type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:P
Last Name:HORL
Suffix:
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 1:61 N PARK AVE
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE CENTRE
Mailing Address - State:NY
Mailing Address - Zip Code:11570-4105
Mailing Address - Country:US
Mailing Address - Phone:516-766-5550
Mailing Address - Fax:516-294-6588
Practice Address - Street 1:61 N PARK AVE
Practice Address - Street 2:
Practice Address - City:ROCKVILLE CENTRE
Practice Address - State:NY
Practice Address - Zip Code:11570-4105
Practice Address - Country:US
Practice Address - Phone:516-766-5550
Practice Address - Fax:516-294-6588
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2023-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN0044861213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01116105Medicaid
T71194Medicare UPIN
NY15464Medicare ID - Type Unspecified