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Individual

DALE H LAWRENCE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA

Contact information

Practice address
600 MCCLELLAN ST, @ ST. CLARE'S HOSPITAL ER DEPT., SCHENECTADY, NY 12304-1009
(518) 383-5450
(518) 383-4223
Mailing address
506 N MAIN ST, HERKIMER, NY 13350-1128

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
003249-1
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02405190
NY
Enumeration date
07/07/2006
Last updated
07/09/2007
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