Provider Demographics
NPI:1093755605
Name:S. M. LAGO INTERNAL MEDICINE ASSOCIATES, P.C.
Entity Type:Organization
Organization Name:S. M. LAGO INTERNAL MEDICINE ASSOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:MATTHEW
Authorized Official - Last Name:LAGO
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:610-373-8430
Mailing Address - Street 1:2747 CENTURY BLVD.
Mailing Address - Street 2:SUITE 100
Mailing Address - City:WYOMISSING
Mailing Address - State:PA
Mailing Address - Zip Code:19610
Mailing Address - Country:US
Mailing Address - Phone:610-373-8430
Mailing Address - Fax:
Practice Address - Street 1:2747 CENTURY BLVD.
Practice Address - Street 2:SUITE 100
Practice Address - City:WYOMISSING
Practice Address - State:PA
Practice Address - Zip Code:19610
Practice Address - Country:US
Practice Address - Phone:610-373-8430
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS-012237207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty