Provider Demographics
NPI:1497237655
Name:LAUFER, BETZALEL
Entity Type:Individual
Prefix:
First Name:BETZALEL
Middle Name:
Last Name:LAUFER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 RUTLAND RD # 1
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11203-1503
Mailing Address - Country:US
Mailing Address - Phone:917-439-6646
Mailing Address - Fax:
Practice Address - Street 1:667 EASTERN PKWY
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11213-3310
Practice Address - Country:US
Practice Address - Phone:917-439-6646
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-05
Last Update Date:2018-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty