Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0221X | Pediatric Dentist | 061880 | NY |
NPI | 1003472580 |
---|---|
Provider Name | Dr. Lauren Alyce Geffen |
First Address | Clifton Park, NY 12065-1302 |
Second Address | Clifton Park, NY 12065-1302 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/05/2019 |
Last Update Date | 31/08/2021 |