Provider Demographics
NPI:1508138884
Name:LAWRENCE PERLMUTTER MD PC
Entity Type:Organization
Organization Name:LAWRENCE PERLMUTTER MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:
Authorized Official - Last Name:PERLMUTTER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:518-472-9111
Mailing Address - Street 1:23 HACKETT BLVD
Mailing Address - Street 2:SUITE 206
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12208-3436
Mailing Address - Country:US
Mailing Address - Phone:518-472-9111
Mailing Address - Fax:518-449-7210
Practice Address - Street 1:23 HACKETT BLVD
Practice Address - Street 2:SUITE 206
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12208-3436
Practice Address - Country:US
Practice Address - Phone:518-472-9111
Practice Address - Fax:518-449-7210
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-02
Last Update Date:2012-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY108815207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty