Provider Demographics
NPI:1396843082
Name:MINARIK, LAWRENCE (MD)
Entity Type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:
Last Name:MINARIK
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 1:530 W 236TH ST
Mailing Address - Street 2:APT 1M
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10463-1748
Mailing Address - Country:US
Mailing Address - Phone:203-300-7985
Mailing Address - Fax:
Practice Address - Street 1:530 W 236TH ST
Practice Address - Street 2:APT 1M
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10463-1748
Practice Address - Country:US
Practice Address - Phone:203-300-7985
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2008-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY189227207U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207U00000XAllopathic & Osteopathic PhysiciansNuclear Medicine