Healthcare Provider Details

I. General information

NPI: 1578980967
Provider Name (Legal Business Name): LAUREN R RICHTER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2014
Last Update Date: 01/11/2024
Certification Date: 01/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3959 BROADWAY
NEW YORK NY
10032-1559
US

IV. Provider business mailing address

622 W 168TH ST PH 17-W307
NEW YORK NY
10032-3720
US

V. Phone/Fax

Practice location:
  • Phone: 212-305-6559
  • Fax:
Mailing address:
  • Phone: 212-305-6559
  • Fax: 212-305-4778

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number288685
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME151783
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code2080P0205X
TaxonomyPediatric Endocrinology Physician
License NumberME151783
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code2083B0002X
TaxonomyObesity Medicine (Preventive Medicine) Physician
License NumberME151783
License Number StateFL
# 5
Primary TaxonomyN
Taxonomy Code2083B0002X
TaxonomyObesity Medicine (Preventive Medicine) Physician
License Number288685
License Number StateNY
# 6
Primary TaxonomyN
Taxonomy Code2083B0002X
TaxonomyObesity Medicine (Preventive Medicine) Physician
License NumberMD482937
License Number StatePA
# 7
Primary TaxonomyN
Taxonomy Code2083C0008X
TaxonomyClinical Informatics Physician
License Number288685
License Number StateNY
# 8
Primary TaxonomyY
Taxonomy Code2080P0205X
TaxonomyPediatric Endocrinology Physician
License Number288685
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: