Provider Demographics
NPI:1629497136
Name:GRINSPAN, LAUREN TAL (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:TAL
Last Name:GRINSPAN
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:BETH
Other - Last Name:TAL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1 GUSTAVE L LEVY PL # 1104
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-6504
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5 E 98TH ST FL 12
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-6501
Practice Address - Country:US
Practice Address - Phone:212-241-8035
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-11
Last Update Date:2021-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY268818207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology