Provider Demographics
NPI:1225599145
Name:NOLAN, LAUREN W (MD)
Entity Type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:W
Last Name:NOLAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:705 BLOOMFIELD AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06002-2480
Mailing Address - Country:US
Mailing Address - Phone:860-286-0444
Mailing Address - Fax:
Practice Address - Street 1:705 BLOOMFIELD AVE STE 101
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD
Practice Address - State:CT
Practice Address - Zip Code:06002-2480
Practice Address - Country:US
Practice Address - Phone:860-286-0444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-26
Last Update Date:2023-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT072457208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics