Provider Demographics
NPI:1881660116
Name:PIAZZA, LAWRENCE (MD)
Entity type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:
Last Name:PIAZZA
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 1:895 UNION ST STE 225
Mailing Address - Street 2:
Mailing Address - City:BANGOR
Mailing Address - State:ME
Mailing Address - Zip Code:04401-3053
Mailing Address - Country:US
Mailing Address - Phone:207-300-4010
Mailing Address - Fax:207-300-4040
Practice Address - Street 1:895 UNION ST STE 225
Practice Address - Street 2:
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401-3053
Practice Address - Country:US
Practice Address - Phone:207-300-4010
Practice Address - Fax:207-300-4040
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-27
Last Update Date:2025-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME013347207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME127190199Medicaid
E72240Medicare UPIN
MM4322Medicare ID - Type Unspecified