Provider Demographics
NPI:1376717611
Name:BLOCK, LAUREN D (MD)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:D
Last Name:BLOCK
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 1:2001 MARCUS AVE
Mailing Address - Street 2:SUITE S160
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11042-2061
Mailing Address - Country:US
Mailing Address - Phone:516-519-5600
Mailing Address - Fax:
Practice Address - Street 1:2001 MARCUS AVE
Practice Address - Street 2:SUITE S160
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11042-2061
Practice Address - Country:US
Practice Address - Phone:516-519-5600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-17
Last Update Date:2013-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0071967207R00000X
NY269958207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine