Provider Demographics
NPI:1851316467
Name:LINCOW, ARNOLD S (DO)
Entity Type:Individual
Prefix:DR
First Name:ARNOLD
Middle Name:S
Last Name:LINCOW
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7622 OGONTZ AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19150-1817
Mailing Address - Country:US
Mailing Address - Phone:215-224-8980
Mailing Address - Fax:215-224-9342
Practice Address - Street 1:7622 OGONTZ AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19150-1817
Practice Address - Country:US
Practice Address - Phone:215-224-8980
Practice Address - Fax:215-224-9342
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2008-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA0S003726L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
018210S003726LOtherHLTHD
113762EEQOtherMED
018210S003726LOtherSRHP
113762OtherBLU
441122065OtherRRMED
0007087040002OtherDPA
0058049000OtherPC65
100100BOtherKMHP
113762OtherHMO
441122065OtherTMED
0058049000OtherKEY65
0058049000OtherPC
113762OtherCAP
0007087040001OtherDPA
0060155000OtherPC
113762EEQOtherMED
C30511OtherMED
PA0007087040001Medicaid
441122065OtherRRMED
113762Medicare ID - Type Unspecified