Provider Demographics
NPI:1053524413
Name:O'BRIEN-TOMICH, LAUREN (MD)
Entity type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:
Last Name:O'BRIEN-TOMICH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7848 OLD YORK RD
Mailing Address - Street 2:
Mailing Address - City:ELKINS PARK
Mailing Address - State:PA
Mailing Address - Zip Code:19027-2541
Mailing Address - Country:US
Mailing Address - Phone:267-287-8892
Mailing Address - Fax:267-287-8902
Practice Address - Street 1:7848 OLD YORK RD
Practice Address - Street 2:
Practice Address - City:ELKINS PARK
Practice Address - State:PA
Practice Address - Zip Code:19027-2541
Practice Address - Country:US
Practice Address - Phone:267-287-8892
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-08
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD430735207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA102086553-0001Medicaid
PA102086553-0001Medicaid