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Individual

JEFFREY L. LAUTIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
741 NORTHFIELD AVE, SUITE 105, WEST ORANGE, NJ 07052-1174
(973) 243-9729
(973) 243-9674
Mailing address
4000 ROUTE 66, SUITE 131, TINTON FALLS, NJ 07753-7300
(732) 383-4189
(732) 383-4171

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
1764691
NY
2085R0204X
Vascular & Interventional Radiology Physician
1764691
NY
2085R0204X
Vascular & Interventional Radiology Physician
Primary
25MA07034700
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
8163901
NJ
Enumeration date
05/24/2006
Last updated
01/26/2023
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