Provider Demographics
NPI:1205269297
Name:LAWLER, ERIC MICHAEL (DPT, OCS)
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:MICHAEL
Last Name:LAWLER
Suffix:
Gender:M
Credentials:DPT, OCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:650 WANTAGH AVE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:LEVITTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:11756-5390
Mailing Address - Country:US
Mailing Address - Phone:516-520-7200
Mailing Address - Fax:516-520-7625
Practice Address - Street 1:650 WANTAGH AVE
Practice Address - Street 2:SUITE 2
Practice Address - City:LEVITTOWN
Practice Address - State:NY
Practice Address - Zip Code:11756-5390
Practice Address - Country:US
Practice Address - Phone:516-520-7200
Practice Address - Fax:516-520-7625
Is Sole Proprietor?:No
Enumeration Date:2013-08-14
Last Update Date:2015-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY036756-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist