Provider Demographics
NPI:1649596636
Name:MARTIN, LAUREN R (MD)
Entity Type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:R
Last Name:MARTIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:R
Other - Last Name:PALLONE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2840 MORRIS AVE
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:NJ
Mailing Address - Zip Code:07083-4851
Mailing Address - Country:US
Mailing Address - Phone:888-244-5373
Mailing Address - Fax:908-686-8968
Practice Address - Street 1:2840 MORRIS AVE
Practice Address - Street 2:
Practice Address - City:UNION
Practice Address - State:NJ
Practice Address - Zip Code:07083-4851
Practice Address - Country:US
Practice Address - Phone:888-244-5373
Practice Address - Fax:908-686-8968
Is Sole Proprietor?:No
Enumeration Date:2010-04-15
Last Update Date:2021-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD042569208000000X
VA0101253386208000000X
NJ25MA10043300208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics