Individual
LAWRENCE PAOLINI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
105 N MAIN ST, CAPE MAY COURT HOUSE, NJ 08210-2119
(609) 465-8788
(609) 465-8643
Mailing address
105 N MAIN ST, PO BOX 177, CAPE MAY COURT HOUSE, NJ 08210-2119
(609) 465-8788
(609) 465-8643
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
25MB05275300
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0057107000
AMERIHEALTH PROVIDER ID
—
01
—
009205
MEDICARE GROUP PTAN
—
01
—
070002459
RAILROAD MEDICARE
—
01
—
223086309
TAX ID
—
Enumeration date
08/17/2006
Last updated
09/15/2010
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