Provider Demographics
NPI:1508945288
Name:MENDELOWITZ, LAWRENCE (MD)
Entity Type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:
Last Name:MENDELOWITZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:755 N BROADWAY STE 560
Mailing Address - Street 2:SLEEPY HOLLOW MEDICAL GROUP AT PHELPS
Mailing Address - City:SLEEPY HOLLOW
Mailing Address - State:NY
Mailing Address - Zip Code:10591-1077
Mailing Address - Country:US
Mailing Address - Phone:914-631-0337
Mailing Address - Fax:914-631-0552
Practice Address - Street 1:755 N BROADWAY STE 560
Practice Address - Street 2:SLEEPY HOLLOW MEDICAL GROUP AT PHELPS
Practice Address - City:SLEEPY HOLLOW
Practice Address - State:NY
Practice Address - Zip Code:10591-1077
Practice Address - Country:US
Practice Address - Phone:914-631-0337
Practice Address - Fax:914-631-0552
Is Sole Proprietor?:No
Enumeration Date:2006-11-03
Last Update Date:2011-03-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY131776-1207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00508558Medicaid
NY00508558Medicaid
B13354Medicare UPIN