Individual
LAWRENCE KOSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3045 EAST AVE, LIFETIME HEALTH CENTER BUILDING, CENTRAL SQUARE, NY 13036-9502
(315) 668-1202
Mailing address
7277 SNOWBALL RUN, EAST SYRACUSE, NY 13057-3212
(315) 656-2698
(206) 426-2313
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
208062
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00355266
—
NY
Enumeration date
09/21/2006
Last updated
10/20/2010
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