Provider Demographics
NPI:1982648218
Name:AMSEL, LAWRENCE V (MD)
Entity Type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:V
Last Name:AMSEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:DEPT OF PSYCHIATRY, TRUSTEES OF COLUMBIA UNIVERSITY
Mailing Address - Street 2:622 WEST 168TH STREET, BOX 260
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032
Mailing Address - Country:US
Mailing Address - Phone:212-305-2330
Mailing Address - Fax:212-305-4724
Practice Address - Street 1:MILSTEIN 9 GARDEN NORTH
Practice Address - Street 2:177 FORT WASHINGTON AVENUE
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032
Practice Address - Country:US
Practice Address - Phone:212-305-3090
Practice Address - Fax:212-305-4724
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2008-04-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY1900182084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01599908Medicaid
NYG17224Medicare UPIN
NY30M811Medicare ID - Type Unspecified