Provider Demographics
NPI:1316362288
Name:MADHOK, LORI ANN
Entity Type:Individual
Prefix:
First Name:LORI ANN
Middle Name:
Last Name:MADHOK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1687
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20849-1687
Mailing Address - Country:US
Mailing Address - Phone:301-649-7170
Mailing Address - Fax:301-260-8487
Practice Address - Street 1:7 SAINT PAUL ST
Practice Address - Street 2:SUITE 1660
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21202-1626
Practice Address - Country:US
Practice Address - Phone:301-649-7170
Practice Address - Fax:301-260-8487
Is Sole Proprietor?:No
Enumeration Date:2014-02-28
Last Update Date:2014-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist