Provider Demographics
NPI:1821271479
Name:BARUSCH, LAWRENCE (RPH)
Entity Type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:
Last Name:BARUSCH
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:660 HOOSICK RD
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:NY
Mailing Address - Zip Code:12180-8812
Mailing Address - Country:US
Mailing Address - Phone:518-273-8651
Mailing Address - Fax:518-270-0836
Practice Address - Street 1:660 HOOSICK RD
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:NY
Practice Address - Zip Code:12180-8812
Practice Address - Country:US
Practice Address - Phone:518-273-8651
Practice Address - Fax:518-270-0836
Is Sole Proprietor?:No
Enumeration Date:2007-12-06
Last Update Date:2007-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY34629183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist