Provider Demographics
NPI:1437223476
Name:ST LAWRENCE INTERNISTS PC
Entity Type:Organization
Organization Name:ST LAWRENCE INTERNISTS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAYANT
Authorized Official - Middle Name:J
Authorized Official - Last Name:JHAVERI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:315-764-0221
Mailing Address - Street 1:267 ANDREWS ST
Mailing Address - Street 2:
Mailing Address - City:MASSENA
Mailing Address - State:NY
Mailing Address - Zip Code:13662-3401
Mailing Address - Country:US
Mailing Address - Phone:315-764-0221
Mailing Address - Fax:315-764-1395
Practice Address - Street 1:267 ANDREWS ST
Practice Address - Street 2:
Practice Address - City:MASSENA
Practice Address - State:NY
Practice Address - Zip Code:13662-3401
Practice Address - Country:US
Practice Address - Phone:315-764-0221
Practice Address - Fax:315-764-1395
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-20
Last Update Date:2013-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty