Provider Demographics
NPI:1285625665
Name:INTERNAL MEDICINE ASSOCIATES OF LAWRENCE COUNTY, P.C.
Entity type:Organization
Organization Name:INTERNAL MEDICINE ASSOCIATES OF LAWRENCE COUNTY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JERZY
Authorized Official - Middle Name:K
Authorized Official - Last Name:MAGDA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:724-658-6656
Mailing Address - Street 1:125 ENCLAVE DR
Mailing Address - Street 2:
Mailing Address - City:NEW CASTLE
Mailing Address - State:PA
Mailing Address - Zip Code:16105-3207
Mailing Address - Country:US
Mailing Address - Phone:724-658-6656
Mailing Address - Fax:724-658-6542
Practice Address - Street 1:125 ENCLAVE DR
Practice Address - Street 2:
Practice Address - City:NEW CASTLE
Practice Address - State:PA
Practice Address - Zip Code:16105-3207
Practice Address - Country:US
Practice Address - Phone:724-658-6656
Practice Address - Fax:724-658-6542
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-03
Last Update Date:2022-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1514246OtherGATEWAY
PAIN542479OtherBLUE SHIELD
PA621487OtherTRIGON
PA114792OtherTHREE RIVERS/MED PLUS
PA134141OtherHEALTH AMERICA/ASSURANCE
PAA686OtherUPMC
PADB6644OtherRAILROAD MEDICARE
PA94508OtherAETNA US HEALTHCARE
PA0018423680005Medicaid
PA134141OtherHEALTH AMERICA/ASSURANCE