Pearl A Lake

Primary specialty

Military Health Care ProviderTaxonomy code 171000000X

License

7000.000000634RMA Issued in PA

Practice address

2214 S 57TH St
Philadelphia, PA 19143-5705

Phone

(886) 884-8807

Fax

(215) 825-5161

NPI assigned

Dec 12, 2020

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1607731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607731200000",
    "number": "1053907261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2250 E MONMOUTH ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191344103",
            "telephone_number": "267-884-8807",
            "fax_number": "215-825-5161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2214 S 57TH ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191435705",
            "telephone_number": "886-884-8807",
            "fax_number": "215-825-5161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAKE",
        "first_name": "PEARL",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-12-12",
        "last_updated": "2020-12-12",
        "certification_date": "2020-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Military Health Care Provider",
            "state": "PA",
            "license": "70000634RMA",
            "primary": false
        },
        {
            "code": "171000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Military Health Care Provider",
            "state": "PA",
            "license": "7000.000000634RMA",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laila Way
• Christine A. Laine, M.D.
• Pablo Laje, M.D.
• Allison Michelle Lake, MD,PHD
• Jonathan Ian Lake, M.D.
• Hannah Lakehomer Drew, CNM
• Lakeva Hamilton-Killion
• Alyshah Lakhani, MD
• Paras C Lakhani, MD
• Aparna Lakshminarasimhan, MD

• Military Health Care Provider in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Military Health Care Provider in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.