Provider Demographics
NPI:1205990702
Name:MEITELES, LAWRENCE Z (MD)
Entity type:Individual
Prefix:MR
First Name:LAWRENCE
Middle Name:Z
Last Name:MEITELES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:660 WHITE PLAINS RD FL 4
Mailing Address - Street 2:
Mailing Address - City:TARRYTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10591-5139
Mailing Address - Country:US
Mailing Address - Phone:914-984-2546
Mailing Address - Fax:
Practice Address - Street 1:2651 STRANG BLVD
Practice Address - Street 2:
Practice Address - City:YORKTOWN HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:10598-2909
Practice Address - Country:US
Practice Address - Phone:914-245-2681
Practice Address - Fax:914-245-8037
Is Sole Proprietor?:No
Enumeration Date:2006-12-20
Last Update Date:2019-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY171636207Y00000X, 207YX0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0901XAllopathic & Osteopathic PhysiciansOtolaryngologyOtology & Neurotology
No207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYF36501Medicare UPIN
NY7M0062Medicare ID - Type Unspecified
NYF36501Medicare UPIN