Provider Demographics
NPI:1356348908
Name:WARTEL, LAWRENCE J (MD)
Entity type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:J
Last Name:WARTEL
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 1:675 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CHESHIRE
Mailing Address - State:CT
Mailing Address - Zip Code:06410-3153
Mailing Address - Country:US
Mailing Address - Phone:203-250-2125
Mailing Address - Fax:203-250-2162
Practice Address - Street 1:675 S MAIN ST
Practice Address - Street 2:
Practice Address - City:CHESHIRE
Practice Address - State:CT
Practice Address - Zip Code:06410-3153
Practice Address - Country:US
Practice Address - Phone:203-272-1811
Practice Address - Fax:203-271-3152
Is Sole Proprietor?:No
Enumeration Date:2005-06-28
Last Update Date:2008-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT013084207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTNHP099OtherOXFORD HEALTH PLAN
CT160007832OtherMEDICARE RAILROAD
CT524517OtherAETNA
CT0201418-002OtherCIGNA
DE0Q0328OtherHEALTHNET
CT010013084CT01OtherANTHEM BLUE CROSS & BLUE SHEILD OF CT
CT07-40924OtherUNITED HEALTH CARE
CT001130848Medicaid
DE013084OtherCONNECTICARE
CT160007832OtherMEDICARE RAILROAD
CTNHP099OtherOXFORD HEALTH PLAN