Provider Demographics
NPI:1841876455
Name:LAWRENCE, CARLTON (MD (CONFERRED 05/21))
Entity type:Individual
Prefix:
First Name:CARLTON
Middle Name:
Last Name:LAWRENCE
Suffix:
Gender:M
Credentials:MD (CONFERRED 05/21)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 AMSTERDAM AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-5752
Mailing Address - Country:US
Mailing Address - Phone:212-749-1820
Mailing Address - Fax:
Practice Address - Street 1:801 AMSTERDAM AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-5752
Practice Address - Country:US
Practice Address - Phone:212-749-1820
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-23
Last Update Date:2024-07-02
Deactivation Date:2021-03-23
Deactivation Code:
Reactivation Date:2021-04-14
Provider Licenses
StateLicense IDTaxonomies
NY329600208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics