Provider Demographics
NPI:1720082662
Name:PINCUS, LAWRENCE G (MD)
Entity Type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:G
Last Name:PINCUS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:100 MLK JR BLVD
Mailing Address - Street 2:2ND FL
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01608-1209
Mailing Address - Country:US
Mailing Address - Phone:508-757-1589
Mailing Address - Fax:508-756-5633
Practice Address - Street 1:100 MLK JR BLVD
Practice Address - Street 2:2ND FL
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01608-1209
Practice Address - Country:US
Practice Address - Phone:508-757-1589
Practice Address - Fax:508-756-5633
Is Sole Proprietor?:No
Enumeration Date:2005-06-09
Last Update Date:2008-09-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA216605207KA0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1530OtherHARVARD PILGRIM
MA0200265OtherUNITED HEALTHCARE
MA216605OtherTUFTS HEALTHPLAN
MA67551OtherFALLON
MA2044960Medicaid
MA3076792OtherAETNA US HEALTHCARE
MA973519OtherNETWORK HEALTH
MAJ26487OtherBLUE CROSS BLUE SHIELD
MA0029831OtherNEIGHBORHOOD HEALTH PLAN
MA042923137OtherTAX ID GROUP NUMBER
MA326052OtherCIGNA HEALTHCARE
MA973519OtherNETWORK HEALTH
MA216605OtherTUFTS HEALTHPLAN