Healthcare Provider Details
I. General information
NPI: 1770902868
Provider Name (Legal Business Name): LAUREN RECHTMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/16/2014
Last Update Date: 07/12/2017
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
111 MICHIGAN AVE NW
WASHINGTON DC
20010-2916
US
IV. Provider business mailing address
111 MICHIGAN AVE NW
WASHINGTON DC
20010-2916
US
V. Phone/Fax
- Phone: 202-476-3670
- Fax: 202-476-4741
- Phone: 202-476-3670
- Fax: 202-476-4741
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 390200000X |
| Taxonomy | Student in an Organized Health Care Education/Training Program |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | D0082906 |
| License Number State | MD |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: