MEDICARE: MS. LAUREN ATTERMANN MSOT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	366189	NJ

General Provider Information

NPI Number	:	1609314764
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LAUREN ATTERMANN MSOT

Provider Business Mailing Address
First Line	:	201 E 15TH ST
Second Line	:	5A
City	:	NEW YORK
State	:	NY
Zip	:	10003-3723
Country	:	US
Telephone Number	:	201-207-9169
Fax Number	:

Provider Business Practice Location Address
First Line	:	201 E 15TH ST
Second Line	:	5A
City	:	NEW YORK
State	:	NY
Zip	:	10003-3723
Country	:	US
Telephone Number	:	201-207-9169
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/08/2017
Last Update Date	:	02/08/2017

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