Provider Demographics
NPI:1144288960
Name:LAWRENCE I KATIN MD
Entity type:Organization
Organization Name:LAWRENCE I KATIN MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:I
Authorized Official - Last Name:KATIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:610-647-6070
Mailing Address - Street 1:255 W LANCASTER AVE
Mailing Address - Street 2:STE 224
Mailing Address - City:PAOLI
Mailing Address - State:PA
Mailing Address - Zip Code:19301
Mailing Address - Country:US
Mailing Address - Phone:610-647-6070
Mailing Address - Fax:610-647-6851
Practice Address - Street 1:255 W LANCASTER AVE
Practice Address - Street 2:STE 224
Practice Address - City:PAOLI
Practice Address - State:PA
Practice Address - Zip Code:19301
Practice Address - Country:US
Practice Address - Phone:610-647-6070
Practice Address - Fax:610-647-6851
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
669793Medicare ID - Type Unspecified