Provider Demographics
NPI:1164176368
Name:KIEFER, LAUREN MEREDITH (LAC)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:MEREDITH
Last Name:KIEFER
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:271 COLUMBIA ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11231-5822
Mailing Address - Country:US
Mailing Address - Phone:917-374-4590
Mailing Address - Fax:
Practice Address - Street 1:271 COLUMBIA ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11231-5822
Practice Address - Country:US
Practice Address - Phone:917-374-4590
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-07
Last Update Date:2022-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171100000X
007063171100000X
NY007063171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist