Provider Demographics
NPI:1467687061
Name:NOTARO, LAWRENCE ALDO (MD)
Entity Type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:ALDO
Last Name:NOTARO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1601 MCDANIEL DR STE 50
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19380-7030
Mailing Address - Country:US
Mailing Address - Phone:484-905-8000
Mailing Address - Fax:484-905-8005
Practice Address - Street 1:1601 MCDANIEL DR STE 50
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19380-7030
Practice Address - Country:US
Practice Address - Phone:484-905-8000
Practice Address - Fax:484-905-8005
Is Sole Proprietor?:No
Enumeration Date:2009-05-27
Last Update Date:2020-09-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD447441207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1028548300002Medicaid
PA306101LCKMedicare PIN