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LAWRENCE MICHAEL MALINCONICO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
55 LAKE AVE N, WORCESTER, MA 01655-0002
(508) 421-1400
(508) 421-1490
Mailing address
PO BOX 415348, BOSTON, MA 02241-5348

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
1015066
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
110163528A
MA
Enumeration date
03/29/2020
Last updated
03/27/2023
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