Provider Demographics
NPI:1356759245
Name:LAWRENCE, STEPHEN (RN, EMT-P)
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:
Last Name:LAWRENCE
Suffix:
Gender:M
Credentials:RN, EMT-P
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 MORNINGSIDE AVE APT 26
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10026-2328
Mailing Address - Country:US
Mailing Address - Phone:212-662-3215
Mailing Address - Fax:
Practice Address - Street 1:14 MORNINGSIDE AVE APT 26
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10026-2328
Practice Address - Country:US
Practice Address - Phone:212-662-3215
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-24
Last Update Date:2014-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY648654163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse