Provider Demographics
NPI:1407909302
Name:BUMBY, LAUREN ANNE (MD)
Entity Type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:ANNE
Last Name:BUMBY
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 1:10 SOUTH ST STE 201
Mailing Address - Street 2:
Mailing Address - City:RIDGEFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06877-4126
Mailing Address - Country:US
Mailing Address - Phone:203-431-0111
Mailing Address - Fax:
Practice Address - Street 1:10 SOUTH ST STE 201
Practice Address - Street 2:
Practice Address - City:RIDGEFIELD
Practice Address - State:CT
Practice Address - Zip Code:06877-4126
Practice Address - Country:US
Practice Address - Phone:203-431-0111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT044982207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine