Provider Demographics
NPI:1942601240
Name:BADER, LAUREN (MD)
Entity Type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:
Last Name:BADER
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 1:304 RIVER RUN
Mailing Address - Street 2:
Mailing Address - City:GREENWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06831-4166
Mailing Address - Country:US
Mailing Address - Phone:203-216-0275
Mailing Address - Fax:
Practice Address - Street 1:106 NOROTON AVE
Practice Address - Street 2:DEPARTMENT OF PEDIATRICS
Practice Address - City:DARIEN
Practice Address - State:CT
Practice Address - Zip Code:06820-5237
Practice Address - Country:US
Practice Address - Phone:203-655-9741
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-06
Last Update Date:2022-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT053703208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics