Individual
LAUREN BOEHM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
550 1ST AVE, NEW YORK, NY 10016-6402
(212) 263-5506
Mailing address
700 HICKSVILLE RD STE 205, BETHPAGE, NY 11714-3472
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
306577
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13-3971298
TISCH
NY
Enumeration date
04/24/2017
Last updated
04/10/2025
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