Provider Demographics
NPI:1841268802
Name:BARUCH, LAWRENCE (MD)
Entity type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:
Last Name:BARUCH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 E 85TH ST
Mailing Address - Street 2:12D
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028-0958
Mailing Address - Country:US
Mailing Address - Phone:917-833-5636
Mailing Address - Fax:
Practice Address - Street 1:451 PARK AVENUE SOUTH, 2ND FLOOR
Practice Address - Street 2:NORTHWELL HEALTH CONCORDE MEDICAL GROUP
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-7376
Practice Address - Country:US
Practice Address - Phone:212-889-5640
Practice Address - Fax:212-684-4775
Is Sole Proprietor?:No
Enumeration Date:2006-03-08
Last Update Date:2024-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY177261207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease