Provider Demographics
NPI:1932273414
Name:BARNARD, LAWRENCE M (DO)
Entity Type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:M
Last Name:BARNARD
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 RAY COURT
Mailing Address - Street 2:
Mailing Address - City:MELVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11747-4148
Mailing Address - Country:US
Mailing Address - Phone:516-316-3872
Mailing Address - Fax:516-249-2081
Practice Address - Street 1:264 HAYPATH RD
Practice Address - Street 2:SUITE 102
Practice Address - City:OLD BETHPAGE
Practice Address - State:NY
Practice Address - Zip Code:11804-1446
Practice Address - Country:US
Practice Address - Phone:516-249-2080
Practice Address - Fax:516-249-2081
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-17
Last Update Date:2015-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY222994204D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMM
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY222994OtherNYS LICENSE
NY34-1977745OtherTAX ID
NY34-1977745OtherTAX ID
NY6Q6412Medicare ID - Type Unspecified