Individual
LAWRENCE ROY BLUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
572 PARK AVENUE, NEW YORK, NY 10021
(212) 751-8374
(212) 751-8379
Mailing address
572 PARK AVE, NEW YORK, NY 10065-7370
(212) 751-8374
(212) 751-8379
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
188611
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01500678
—
NY
Enumeration date
10/04/2006
Last updated
07/23/2008
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