Individual
JEFFREY WILLIAM LAWRENCE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
8616 JAMAICA AVE, JAMAICA, NY 11421-2042
(718) 441-2640
Mailing address
29 DUNLOP CT., COMMACK, NY 11725
(309) 798-6263
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
016950
NY
Other
Enumeration date
09/24/2013
Last updated
09/24/2013
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