Individual
DR. LAWRENCE EIDREF SANTIAGO LIPANA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
333 CEDAR ST # 3, YUSM DEPARTMENT OF ANESTHESIOLOGY, NEW HAVEN, CT 06510-3206
(203) 688-9503
Mailing address
393 E WALNUT ST, PHR GROUP PROVIDER ENROLLMENT UNIT 3RD FL, PASADENA, CA 91188-0001
(877) 608-0044
(877) 514-0903
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
05/04/2010
Last updated
12/08/2021
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