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Individual
LEO P LAWRENCE
Active
Individual
LEO P LAWRENCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
006886-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000490094001
BSNENY
NY
05
—
02393117
—
NY
01
—
114406
VALUE OPTIONS
NY
01
—
141338471
MARTINS POINT
NY
01
—
90031
MVP
NY
01
—
LL04C91710
EMPIRE
NY
Enumeration date
11/29/2006
Last updated
06/18/2013
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