Provider Demographics
NPI:1366431934
Name:CONSLATO, PAUL M (MD)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:M
Last Name:CONSLATO
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2110 HARRISBURG PIKE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601-2644
Mailing Address - Country:US
Mailing Address - Phone:717-544-3191
Mailing Address - Fax:717-544-3637
Practice Address - Street 1:2110 HARRISBURG PIKE
Practice Address - Street 2:SUITE 100
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-2644
Practice Address - Country:US
Practice Address - Phone:717-544-3191
Practice Address - Fax:717-544-3637
Is Sole Proprietor?:No
Enumeration Date:2005-10-17
Last Update Date:2016-09-29
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Provider Licenses
StateLicense IDTaxonomies
PAMD057199L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1519644OtherGATEWAY HEALTH PLAN
PA7016265OtherAETNA NON-HMO
PA2608284OtherAETNA HMO
PA672795OtherHIGHMARK BLUE SHIELD
PAP002537OtherGATEWAY HEALTH PLAN
PA110190762OtherRAILROAD MEDICARE
PA59345 S1QAOtherGEISINGER HEALTH PLAN
PA02025602OtherCAPITAL BLUE CROSS
PAG99464OtherHEALTH ASSURANCE
PA0017571310003Medicaid
PA672795OtherHIGHMARK BLUE SHIELD
PA0017571310003Medicaid