MEDICARE: DR. LAUREN RENEE KEIZER-NATHAN DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	052030	NY

General Provider Information

NPI Number	:	1457373037
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LAUREN RENEE KEIZER-NATHAN DDS

Provider Business Mailing Address
First Line	:	60 W 23RD ST
Second Line	:	APARTMENT #842
City	:	NEW YORK
State	:	NY
Zip	:	10010-5283
Country	:	US
Telephone Number	:	646-808-4501
Fax Number	:

Provider Business Practice Location Address
First Line	:	450 PARK AVE S
Second Line	:	SUITE 200
City	:	NEW YORK
State	:	NY
Zip	:	10016-7320
Country	:	US
Telephone Number	:	212-725-6001
Fax Number	:	212-725-6090

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/24/2006
Last Update Date	:	07/31/2007

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Directions to “ DR. LAUREN RENEE KEIZER-NATHAN DDS” Practice Location

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