Healthcare Provider Details

I. General information

NPI: 1205993243
Provider Name (Legal Business Name): LAWRENCE ZEROLNICK MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/02/2007
Last Update Date: 11/14/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7141 SECURITY BOULEVARD
BALTIMORE MD
21244-1811
US

IV. Provider business mailing address

2101 EAST JEFFERSON STREET PPQA MEDICARE COMPLIANCE UNIT 6 WEST
ROCKVILLE MD
20852-4908
US

V. Phone/Fax

Practice location:
  • Phone: 443-663-6000
  • Fax: 443-563-6172
Mailing address:
  • Phone: 301-816-6660
  • Fax: 301-816-6308

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberD018225
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: