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Individual

GILLIAN L LAUTENBACH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
51 N 39TH ST, PHILADELPHIA, PA 19104-2640
(215) 662-9990
(215) 243-3297
Mailing address
51 N 39TH ST, PHILADELPHIA, PA 19104-2640
(215) 662-9990
(215) 243-3297

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD056948L
PA
208M00000X
Hospitalist Physician
MD056948L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0015995600001
PA
Enumeration date
07/04/2006
Last updated
09/16/2019
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