Individual
TARA LEE LAUTENSLAGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
501 FELLOWSHIP RD, SUITE 101, MOUNT LAUREL, NJ 08054-3419
(856) 642-2133
Mailing address
1 FEDERAL ST # 200, CAMDEN, NJ 08103-1088
(856) 356-4924
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
25MA09466500
NJ
Other
Enumeration date
04/06/2009
Last updated
05/10/2019
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