Provider Demographics
NPI:1295703502
Name:LONKY, LAURENCE (OD)
Entity type:Individual
Prefix:DR
First Name:LAURENCE
Middle Name:
Last Name:LONKY
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 STATION RD
Mailing Address - Street 2:
Mailing Address - City:IRVINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:10533-2138
Mailing Address - Country:US
Mailing Address - Phone:914-591-8610
Mailing Address - Fax:
Practice Address - Street 1:2127 CROMPOND RD
Practice Address - Street 2:SUITE 103
Practice Address - City:CORTLANDT MANOR
Practice Address - State:NY
Practice Address - Zip Code:10567-4329
Practice Address - Country:US
Practice Address - Phone:914-737-2020
Practice Address - Fax:914-737-5436
Is Sole Proprietor?:No
Enumeration Date:2006-03-11
Last Update Date:2009-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV004157-1152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYU38635Medicare UPIN
NY0441270001Medicare NSC
NYC68902Medicare ID - Type Unspecified