Organization
105 EAST 78 STREET MEDICAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EVERETT LAUTIN M.D. (PRESIDENT)
(212) 535-3313
Entity
Organization
Contact information
Practice address
885 PARK AVE, SUITE 105, NEW YORK, NY 10075-0325
(212) 535-3313
(212) 734-3192
Mailing address
885 PARK AVE, SUITE 105, NEW YORK, NY 10075-0325
(212) 535-3313
(212) 734-3192
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
60112817
NY
Other
Enumeration date
03/30/2011
Last updated
03/30/2011
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