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Individual

DR. LAWRENCE BURGREEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
91 PERIMETER RD, ROME, NY 13441-4018
(315) 334-9729
Mailing address
PO BOX 669, ROME, NY 13442-0669
(315) 339-7965

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
153927
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00775273
NY
05
02281134
NY
Enumeration date
08/22/2005
Last updated
12/14/2009
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