MEDICARE: BETSY LANTNER MD

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	207V00000X	Obstetrics & Gynecology Physician	179623	NY

General Provider Information

NPI Number	:	1538155767
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BETSY LANTNER MD

Provider Business Mailing Address
First Line	:	1624 E 14TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11229-1104
Country	:	US
Telephone Number	:	718-376-2220
Fax Number	:	718-376-3226

Provider Business Practice Location Address
First Line	:	1624 E 14TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11229-1104
Country	:	US
Telephone Number	:	718-376-2220
Fax Number	:	718-376-3226

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

Provider Enumeration Date	:	09/22/2005
Last Update Date	:	07/08/2007

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