Provider Demographics
NPI:1316909443
Name:LAURO, GREGORY R (MD)
Entity type:Individual
Prefix:
First Name:GREGORY
Middle Name:R
Last Name:LAURO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 EXCELA HEALTH DR STE 204
Mailing Address - Street 2:
Mailing Address - City:LATROBE
Mailing Address - State:PA
Mailing Address - Zip Code:15650-9001
Mailing Address - Country:US
Mailing Address - Phone:724-532-1118
Mailing Address - Fax:724-532-1307
Practice Address - Street 1:100 EXCELA HEALTH DR STE 204
Practice Address - Street 2:
Practice Address - City:LATROBE
Practice Address - State:PA
Practice Address - Zip Code:15650-9001
Practice Address - Country:US
Practice Address - Phone:724-532-1118
Practice Address - Fax:724-532-1307
Is Sole Proprietor?:No
Enumeration Date:2006-04-04
Last Update Date:2025-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD043988L207X00000X, 207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0012759290004Medicaid
PA182388OtherUNISON ADVANTAGE
PA427535OtherH AMERICA/H ASSURANCE ID
PA427535OtherH AMERICA/H ASSURANCE ID
PAP00268880Medicare PIN
PA182388OtherUNISON ADVANTAGE
PA155629Medicare PIN
PA0012759290004Medicaid
PA0012759290004Medicaid