Individual
DR. LAWRENCE JOHN WAITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
382 W CHURCH ST, ELMIRA, NY 14901-2621
(607) 733-2694
(607) 733-1139
Mailing address
382 W CHURCH ST, ELMIRA, NY 14901-2621
(607) 733-2694
(607) 733-1139
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
TUV4209-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OVS71
BC&BS
NY
Enumeration date
07/08/2005
Last updated
11/06/2007
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