Provider Demographics
NPI:1427147503
Name:ZELONIS, LAWRENCE J (DO)
Entity type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:J
Last Name:ZELONIS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2403 S PARK RD
Mailing Address - Street 2:
Mailing Address - City:BETHEL PARK
Mailing Address - State:PA
Mailing Address - Zip Code:15102-3645
Mailing Address - Country:US
Mailing Address - Phone:412-835-3300
Mailing Address - Fax:412-831-7994
Practice Address - Street 1:1610 N MAIN STREET EXT
Practice Address - Street 2:
Practice Address - City:BUTLER
Practice Address - State:PA
Practice Address - Zip Code:16001-1513
Practice Address - Country:US
Practice Address - Phone:724-234-1370
Practice Address - Fax:724-841-0343
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2019-09-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAOS003959-L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAZE23488Medicare ID - Type Unspecified
PAB33483Medicare UPIN