Provider Demographics
NPI:1487651865
Name:PICCIONI, LAWRENCE (MD)
Entity Type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:
Last Name:PICCIONI
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 1:260 BEISER BLVD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19904-7790
Mailing Address - Country:US
Mailing Address - Phone:302-730-8060
Mailing Address - Fax:302-730-8063
Practice Address - Street 1:260 BEISER BLVD
Practice Address - Street 2:SUITE 101
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19904-7790
Practice Address - Country:US
Practice Address - Phone:302-730-8060
Practice Address - Fax:302-730-8063
Is Sole Proprietor?:No
Enumeration Date:2005-06-30
Last Update Date:2007-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC1003B68207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
D71431Medicare UPIN
G01500L01Medicare PIN