Provider Demographics
NPI:1720150352
Name:FILAK, LAWRENCE ANDREW JR (OD)
Entity Type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:ANDREW
Last Name:FILAK
Suffix:JR
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:73 E FORREST AVE
Mailing Address - Street 2:STE 150
Mailing Address - City:SHREWSBURY
Mailing Address - State:PA
Mailing Address - Zip Code:17361-1400
Mailing Address - Country:US
Mailing Address - Phone:717-235-1873
Mailing Address - Fax:717-235-2087
Practice Address - Street 1:73 E FORREST AVE
Practice Address - Street 2:STE 150
Practice Address - City:SHREWSBURY
Practice Address - State:PA
Practice Address - Zip Code:17361-1400
Practice Address - Country:US
Practice Address - Phone:717-235-1873
Practice Address - Fax:717-235-2087
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-15
Last Update Date:2008-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG000542152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA067760Medicare PIN
PAU94200Medicare UPIN