Provider Demographics
NPI:1639315658
Name:LAWRENCE NALITT
Entity Type:Organization
Organization Name:LAWRENCE NALITT
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:NALITT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-388-6123
Mailing Address - Street 1:820 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11206-7305
Mailing Address - Country:US
Mailing Address - Phone:718-388-6123
Mailing Address - Fax:
Practice Address - Street 1:820 BROADWAY
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11206-7305
Practice Address - Country:US
Practice Address - Phone:718-388-6123
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-22
Last Update Date:2008-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty