Healthcare Provider Details

I. General information

NPI: 1962970079
Provider Name (Legal Business Name): LAUREN WHITNEY KOBREN PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/06/2018
Last Update Date: 05/14/2020
Certification Date: 05/14/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 1ST AVE
NEW YORK NY
10016-6402
US

IV. Provider business mailing address

50 MORGAN DR
OLD WESTBURY NY
11568-1010
US

V. Phone/Fax

Practice location:
  • Phone: 212-263-7000
  • Fax:
Mailing address:
  • Phone: 516-242-6885
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number064035
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: