Provider Demographics
NPI:1447832779
Name:LAWRENCE CECCHI MD PC
Entity type:Organization
Organization Name:LAWRENCE CECCHI MD PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:M
Authorized Official - Last Name:CECCHI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:315-425-7722
Mailing Address - Street 1:475 IRVING AVE STE 420
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13210-1573
Mailing Address - Country:US
Mailing Address - Phone:315-425-7722
Mailing Address - Fax:315-475-1705
Practice Address - Street 1:6157 US ROUTE 20
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:NY
Practice Address - Zip Code:13084
Practice Address - Country:US
Practice Address - Phone:315-425-7722
Practice Address - Fax:315-475-1705
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-26
Last Update Date:2021-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier