Provider Demographics
NPI:1902801269
Name:FIELD, LAWRENCE HENRY (MDFAAPMR)
Entity Type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:HENRY
Last Name:FIELD
Suffix:
Gender:M
Credentials:MDFAAPMR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 RUSTLEWOOD RDG
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:MA
Mailing Address - Zip Code:01062-1111
Mailing Address - Country:US
Mailing Address - Phone:413-584-2684
Mailing Address - Fax:
Practice Address - Street 1:780 CHESTNUT ST
Practice Address - Street 2:STE 22
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01107-1610
Practice Address - Country:US
Practice Address - Phone:413-846-4330
Practice Address - Fax:413-846-4332
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-14
Last Update Date:2013-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA58752208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3030288Medicaid
MAC34571Medicare UPIN
MA3030288Medicaid