Individual
DR. LAUREN ELAINE PROVINI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
11 WOODLAND RD STE 1, MADISON, CT 06443-2380
(203) 421-2055
(203) 868-0882
Mailing address
11 WOODLAND RD STE 1, MADISON, CT 06443-2380
(203) 421-2055
(203) 868-0882
Taxonomy
Speciality
Code
Description
License number
State
207NP0225X
Pediatric Dermatology Physician
Primary
70873
CT
208000000X
Pediatrics Physician
Primary
MT212733
PA
Other
Enumeration date
06/02/2017
Last updated
08/06/2026
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