Provider Demographics
NPI:1235149782
Name:LAWRENCE GASTROENTEROLOGY, PA
Entity Type:Organization
Organization Name:LAWRENCE GASTROENTEROLOGY, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:DEANTONIO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:609-882-2185
Mailing Address - Street 1:PO BOX 914
Mailing Address - Street 2:
Mailing Address - City:PENNINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08534-0914
Mailing Address - Country:US
Mailing Address - Phone:609-882-2185
Mailing Address - Fax:
Practice Address - Street 1:3100 PRINCETON PIKE
Practice Address - Street 2:BLDG 4, SUITE C
Practice Address - City:LAWRENCEVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08648
Practice Address - Country:US
Practice Address - Phone:609-882-2185
Practice Address - Fax:609-882-0347
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-08
Last Update Date:2013-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty