Provider Demographics
NPI:1205897139
Name:LAWRENCE, CYNTHIA JEAN (OD)
Entity type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:JEAN
Last Name:LAWRENCE
Suffix:
Gender:F
Credentials:OD
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Mailing Address - Street 1:1 MEDICAL CENTER DR
Mailing Address - Street 2:DHMC DEPT OF OPHTHALMOLOGY
Mailing Address - City:LEBANON
Mailing Address - State:NH
Mailing Address - Zip Code:03756-1000
Mailing Address - Country:US
Mailing Address - Phone:603-650-2651
Mailing Address - Fax:603-650-2659
Practice Address - Street 1:1 MEDICAL CENTER DR
Practice Address - Street 2:DHMC DEPT OF OPHTHALMOLOGY
Practice Address - City:LEBANON
Practice Address - State:NH
Practice Address - Zip Code:03756-1000
Practice Address - Country:US
Practice Address - Phone:603-650-2651
Practice Address - Fax:603-650-2659
Is Sole Proprietor?:No
Enumeration Date:2006-03-30
Last Update Date:2011-07-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NH0629152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH80002385Medicaid
VT1018115Medicaid
VT1018115Medicaid
NHRE403801Medicare PIN