Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | 220613 | NY |
NPI | 1013956796 |
---|---|
Provider Name | Lawrence I Ross |
First Address | Milford, PA 18337-9490 |
Second Address | Woodbury, NY 11797-2922 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/06/2006 |
Last Update Date | 06/08/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H41916 | (02) | NY |