Healthcare Provider Details

I. General information

NPI: 1598394199
Provider Name (Legal Business Name): LAUREN GARDINER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/06/2020
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5200 CENTRE AVE STE 211
PITTSBURGH PA
15232-1312
US

IV. Provider business mailing address

4221 CALVIN ST
PITTSBURGH PA
15201-1116
US

V. Phone/Fax

Practice location:
  • Phone: 412-647-2100
  • Fax:
Mailing address:
  • Phone: 703-953-0754
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207YS0123X
TaxonomyFacial Plastic Surgery Physician
License NumberMD495131
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: