Basic Information
| Provider Information | |||||||||
| NPI: | 1285807628 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SIEGEL | ||||||||
| FirstName: | LAWRENCE | ||||||||
| MiddleName: | JAY | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D., M.P.H. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 119 W 24TH ST | ||||||||
| Address2: | GROUND FLOOR | ||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100111913 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2127467200 | ||||||||
| FaxNumber: | 2127468675 | ||||||||
| Practice Location | |||||||||
| Address1: | 119 W 24TH ST | ||||||||
| Address2: | GROUND FLOOR | ||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100111913 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2127467200 | ||||||||
| FaxNumber: | 2127468675 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/07/2008 | ||||||||
| LastUpdateDate: | 01/03/2012 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RI0200X | 235928 | NY | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Infectious Disease |
No ID Information.