MEDICARE: JONATHAN BENJAMIN LAUTER MD

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	2084P0804X	Child & Adolescent Psychiatry Physician	240592	NY

General Provider Information

NPI Number	:	1770501165
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JONATHAN BENJAMIN LAUTER MD

Provider Business Mailing Address
First Line	:	414 7TH ST APT 1
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11215-3647
Country	:	US
Telephone Number	:	646-593-1221
Fax Number	:	646-596-7015

Provider Business Practice Location Address
First Line	:	48 W 21ST ST FL 4
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10010-7314
Country	:	US
Telephone Number	:	646-593-1221
Fax Number	:	646-596-7015

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

Provider Enumeration Date	:	07/17/2006
Last Update Date	:	07/25/2025

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