Individual
LAUREN ROSE DIERLAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
7385 S BROADWAY # 2, RED HOOK, NY 12571-1745
(845) 758-1456
(845) 758-9590
Mailing address
7385 S BROADWAY, # 2, RED HOOK, NY 12571-1745
(914) 772-4656
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Enumeration date
08/02/2016
Last updated
02/27/2019
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