MEDICARE: DR. LAWRENCE S BOROW M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	MD012802E	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MD012802E	OTHER	PA	PA MEDICAL LICENSE
2	158729	OTHER	PA	BLUE SHIELD OF PA.
3	32005	OTHER	PA	AETNA HEALTH INSURANCE
4	0045404000	OTHER	PA	KEYSTONE HEALTH PLAN EAST

General Provider Information

NPI Number	:	1326043886
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LAWRENCE S BOROW M.D.

Provider Business Mailing Address
First Line	:	146 MONTGOMERY AVE
Second Line	:	STE 200
City	:	BALA CYNWYD
State	:	PA
Zip	:	19004-2956
Country	:	US
Telephone Number	:	610-668-1170
Fax Number	:	610-668-7922

Provider Business Practice Location Address
First Line	:	146 MONTGOMERY AVE
Second Line	:	STE 200
City	:	BALA CYNWYD
State	:	PA
Zip	:	19004-2956
Country	:	US
Telephone Number	:	610-668-1170
Fax Number	:	610-668-7922

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/20/2005
Last Update Date	:	03/07/2023

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Directions to “ DR. LAWRENCE S BOROW M.D.” Practice Location

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