Provider Demographics
NPI:1982718086
Name:HURWITZ, LAWRENCE B (MD)
Entity Type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:B
Last Name:HURWITZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:5100 W TAFT RD
Mailing Address - Street 2:SUITE 3J
Mailing Address - City:LIVERPOOL
Mailing Address - State:NY
Mailing Address - Zip Code:13088-3807
Mailing Address - Country:US
Mailing Address - Phone:315-452-2250
Mailing Address - Fax:315-452-2252
Practice Address - Street 1:5100 W TAFT RD
Practice Address - Street 2:SUITE 3J
Practice Address - City:LIVERPOOL
Practice Address - State:NY
Practice Address - Zip Code:13088-3807
Practice Address - Country:US
Practice Address - Phone:315-452-2250
Practice Address - Fax:315-452-2252
Is Sole Proprietor?:No
Enumeration Date:2006-08-18
Last Update Date:2012-03-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY0967692084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYB80012Medicare UPIN
LH32419BMedicare ID - Type Unspecified