Provider Demographics
NPI:1942361076
Name:LAINOFF, DAVID (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:
Last Name:LAINOFF
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 S RIDING BLVD FL 2
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19808-3692
Mailing Address - Country:US
Mailing Address - Phone:302-623-2850
Mailing Address - Fax:302-623-2855
Practice Address - Street 1:100 S RIDING BLVD FL 2
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19808-3692
Practice Address - Country:US
Practice Address - Phone:302-623-2850
Practice Address - Fax:302-623-2855
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2019-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD427714207R00000X
DEC1-0013284207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA101545947Medicaid
PA101545947Medicaid
PAF91559Medicare UPIN