Provider Demographics
NPI:1073536389
Name:GILBERT, LORI J (MD)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:J
Last Name:GILBERT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1835 ARCH ST
Mailing Address - Street 2:#610
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19193-0001
Mailing Address - Country:US
Mailing Address - Phone:267-242-4461
Mailing Address - Fax:
Practice Address - Street 1:1835 ARCH ST APT 610
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19103-2776
Practice Address - Country:US
Practice Address - Phone:267-242-4461
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2019-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC1-0013164207L00000X
PAMD421345207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology