Provider Demographics
NPI:1447207154
Name:KRUPP, LAUREN (MD)
Entity Type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:
Last Name:KRUPP
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 E 38TH ST
Mailing Address - Street 2:18 AND 20 FLOORS
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-2708
Mailing Address - Country:US
Mailing Address - Phone:646-501-7500
Mailing Address - Fax:646-754-9593
Practice Address - Street 1:240 E 38TH ST
Practice Address - Street 2:18 AND 20 FLOORS
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-2708
Practice Address - Country:US
Practice Address - Phone:646-501-7500
Practice Address - Fax:646-754-9593
Is Sole Proprietor?:No
Enumeration Date:2006-05-28
Last Update Date:2015-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1594912084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02E922OtherEMPIRE BC/BS
NY01030611Medicaid
NY4621745OtherAETNA
NYA60001Medicare UPIN
NY4621745OtherAETNA