Provider Demographics
NPI:1336282615
Name:PROPPER, LAWRENCE ALLEN (MSW LCSW)
Entity Type:Individual
Prefix:MR
First Name:LAWRENCE
Middle Name:ALLEN
Last Name:PROPPER
Suffix:
Gender:M
Credentials:MSW LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 NORTH COUNTRY RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:MT SINAI
Mailing Address - State:NY
Mailing Address - Zip Code:11766
Mailing Address - Country:US
Mailing Address - Phone:631-928-2596
Mailing Address - Fax:
Practice Address - Street 1:28 NORTH COUNTRY RD
Practice Address - Street 2:SUITE 101
Practice Address - City:MT SINAI
Practice Address - State:NY
Practice Address - Zip Code:11766
Practice Address - Country:US
Practice Address - Phone:631-928-2596
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMR0215181041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
R49257Medicare UPIN
NYN9A161Medicare ID - Type Unspecified