Provider Demographics
NPI:1184115479
Name:LAWRENCE MEDICAL ASSOCIATES, PC
Entity type:Organization
Organization Name:LAWRENCE MEDICAL ASSOCIATES, PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:GERALD
Authorized Official - Middle Name:
Authorized Official - Last Name:RIDGE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:914-787-4100
Mailing Address - Street 1:55 PALMER AVE
Mailing Address - Street 2:
Mailing Address - City:BRONXVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:10708-3403
Mailing Address - Country:US
Mailing Address - Phone:914-787-6029
Mailing Address - Fax:
Practice Address - Street 1:2649 STRANG BLVD STE 304
Practice Address - Street 2:
Practice Address - City:YORKTOWN HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:10598-2938
Practice Address - Country:US
Practice Address - Phone:267-979-8095
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-23
Last Update Date:2021-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty