Healthcare Provider Details

I. General information

NPI: 1205097458
Provider Name (Legal Business Name): LAUREN WILTSHIRE COCHRAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2008
Last Update Date: 11/08/2025
Certification Date: 11/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2021 GRAND CONCOURSE 2ND FLOOR
BRONX NY
10453-4304
US

IV. Provider business mailing address

2021 GRAND CONCOURSE 2ND FLOOR
BRONX NY
10453-4304
US

V. Phone/Fax

Practice location:
  • Phone: 718-901-9546
  • Fax:
Mailing address:
  • Phone: 718-901-9524
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number258578
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: