Provider Demographics
NPI:1952466096
Name:VONRAGO, LAWRENCE LASZLO (MD)
Entity Type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:LASZLO
Last Name:VONRAGO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:LAWRENCE
Other - Middle Name:LASZLO
Other - Last Name:VON RAGO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1035 MUMMA RD
Mailing Address - Street 2:
Mailing Address - City:WORMLEYSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17043-1147
Mailing Address - Country:US
Mailing Address - Phone:717-566-0111
Mailing Address - Fax:
Practice Address - Street 1:1035 MUMMA RD
Practice Address - Street 2:
Practice Address - City:WORMLEYSBURG
Practice Address - State:PA
Practice Address - Zip Code:17043-1147
Practice Address - Country:US
Practice Address - Phone:717-566-0111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-27
Last Update Date:2008-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD053651L2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAG48730Medicare UPIN