Provider Demographics
NPI:1659584902
Name:DEMANN, LAWRENCE E JR
Entity Type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:E
Last Name:DEMANN
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 E 56TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-4136
Mailing Address - Country:US
Mailing Address - Phone:212-688-2016
Mailing Address - Fax:212-753-9856
Practice Address - Street 1:300 E 56TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-4136
Practice Address - Country:US
Practice Address - Phone:212-688-2016
Practice Address - Fax:212-753-9856
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-07
Last Update Date:2008-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2305-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYX02801Medicare PIN