Provider Demographics
NPI:1003012410
Name:TINDOC, LORELANE PAGULAYAN (MD)
Entity Type:Individual
Prefix:DR
First Name:LORELANE
Middle Name:PAGULAYAN
Last Name:TINDOC
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:LORELANE
Other - Middle Name:
Other - Last Name:PAGULAYAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:5730 EXECUTIVE DR STE 230
Mailing Address - Street 2:
Mailing Address - City:CATONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21228-1762
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1 CEDAR CREST VILLAGE DR
Practice Address - Street 2:
Practice Address - City:POMPTON PLAINS
Practice Address - State:NJ
Practice Address - Zip Code:07444-2100
Practice Address - Country:US
Practice Address - Phone:973-831-3540
Practice Address - Fax:973-831-3503
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-22
Last Update Date:2022-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT048737207Q00000X
NJ25MA0883500207Q00000X
390200000X
NJ25MA08833500207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program