Provider Demographics
NPI:1326043886
Name:BOROW, LAWRENCE S (MD)
Entity Type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:S
Last Name:BOROW
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:146 MONTGOMERY AVE
Mailing Address - Street 2:STE 200
Mailing Address - City:BALA CYNWYD
Mailing Address - State:PA
Mailing Address - Zip Code:19004-2956
Mailing Address - Country:US
Mailing Address - Phone:610-668-1170
Mailing Address - Fax:610-668-7922
Practice Address - Street 1:146 MONTGOMERY AVE
Practice Address - Street 2:STE 200
Practice Address - City:BALA CYNWYD
Practice Address - State:PA
Practice Address - Zip Code:19004-2956
Practice Address - Country:US
Practice Address - Phone:610-668-1170
Practice Address - Fax:610-668-7922
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-20
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD012802E174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAMD012802EOtherPA MEDICAL LICENSE
PA158729OtherBLUE SHIELD OF PA.
PA32005OtherAETNA HEALTH INSURANCE
PA0045404000OtherKEYSTONE HEALTH PLAN EAST
PA0045404000OtherKEYSTONE HEALTH PLAN EAST
PAAB4572182OtherPA. DRUG LICENSE
PA4411610542Medicare ID - Type UnspecifiedRALROAD MEDICARE
PA32005OtherAETNA HEALTH INSURANCE