Provider Demographics
NPI:1598107229
Name:LAURIE S LITWIN, DDS, PLLC
Entity Type:Organization
Organization Name:LAURIE S LITWIN, DDS, PLLC
Other - Org Name:GRAMERCY DENTAL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LAURIE
Authorized Official - Middle Name:
Authorized Official - Last Name:LITWIN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:212-614-2662
Mailing Address - Street 1:8 GRAMERCY PARK S
Mailing Address - Street 2:SUITE #1B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-1718
Mailing Address - Country:US
Mailing Address - Phone:212-614-2662
Mailing Address - Fax:
Practice Address - Street 1:8 GRAMERCY PARK S
Practice Address - Street 2:SUITE #1B
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-1718
Practice Address - Country:US
Practice Address - Phone:212-614-2662
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-23
Last Update Date:2013-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY055936122300000X
NY049960122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty