Provider Demographics
NPI:1417315631
Name:LAWRENCE, PATRICIA V
Entity Type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:V
Last Name:LAWRENCE
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:PATRICIA
Other - Middle Name:V
Other - Last Name:LAWRENCE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSED
Mailing Address - Street 1:400 E 96TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11212-2623
Mailing Address - Country:US
Mailing Address - Phone:347-406-5283
Mailing Address - Fax:
Practice Address - Street 1:400 E 96TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11212-2623
Practice Address - Country:US
Practice Address - Phone:347-406-5283
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-02
Last Update Date:2016-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist