Provider Demographics
NPI:1750572517
Name:LAWRENCE K ALWINE D O
Entity type:Organization
Organization Name:LAWRENCE K ALWINE D O
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:HEAD OF PRACTICE
Authorized Official - Prefix:DR
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:KENNETH
Authorized Official - Last Name:ALWINE
Authorized Official - Suffix:
Authorized Official - Credentials:D O
Authorized Official - Phone:610-269-9570
Mailing Address - Street 1:77 MANOR AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:DOWNINGTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19335-2620
Mailing Address - Country:US
Mailing Address - Phone:610-269-9570
Mailing Address - Fax:610-269-3568
Practice Address - Street 1:77 MANOR AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:DOWNINGTOWN
Practice Address - State:PA
Practice Address - Zip Code:19335-2620
Practice Address - Country:US
Practice Address - Phone:610-269-9570
Practice Address - Fax:610-269-3568
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-07
Last Update Date:2008-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA065671Medicare PIN