Provider Demographics
NPI:1578993259
Name:LAWDOC
Entity Type:Organization
Organization Name:LAWDOC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:
Authorized Official - Last Name:CHIARULLI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:914-238-6259
Mailing Address - Street 1:15 OLD LYME RD
Mailing Address - Street 2:
Mailing Address - City:CHAPPAQUA
Mailing Address - State:NY
Mailing Address - Zip Code:10514-3805
Mailing Address - Country:US
Mailing Address - Phone:914-238-6259
Mailing Address - Fax:
Practice Address - Street 1:15 OLD LYME RD
Practice Address - Street 2:
Practice Address - City:CHAPPAQUA
Practice Address - State:NY
Practice Address - Zip Code:10514-3805
Practice Address - Country:US
Practice Address - Phone:914-238-6259
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-18
Last Update Date:2013-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY163107207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty