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General NPI Number Information
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NPI Number | 1063528677
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Entity Type | Organization
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Legal Business Name | DR. DAVID M LAUREN, INC
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Dates
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Enumeration Date | 08/23/2006
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Last Update Date | 11/08/2010
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Provider Practice Location Address
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Address Line | 113 WESLEY DR
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City | HUNTINGTON
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State | CT
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Zip | 06484-5248
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Country | US
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Telephone | 203-929-2165
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Fax | 203-929-2165
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Provider Business Mailing Address
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Address Line | 113 WESLEY DR
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City | HUNTINGTON
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State | CT
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Zip | 06484-5248
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Country | US
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Telephone | 203-929-2165
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Fax | 203-929-2165
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. DAVID M LAUREN
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Credential | D.O.
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Telephone | 203-929-2165
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 47449
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License Number State | CT
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