Individual
EILEEN M LAWRENCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
162 E MAIN ST, CLINTON, CT 06413-2116
(860) 669-7272
(860) 669-3337
Mailing address
162 E MAIN ST, CLINTON, CT 06413-2116
(860) 669-7272
(860) 669-3337
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
036800
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001368001
—
CT
Enumeration date
01/19/2006
Last updated
07/08/2007
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