Provider Demographics
NPI:1265696108
Name:LAUTIN, ANDREW L (MD)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:L
Last Name:LAUTIN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1148 5TH AVE
Mailing Address - Street 2:10A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-0807
Mailing Address - Country:US
Mailing Address - Phone:212-348-6983
Mailing Address - Fax:
Practice Address - Street 1:37 FRONT ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:GREENPORT
Practice Address - State:NY
Practice Address - Zip Code:11944-1639
Practice Address - Country:US
Practice Address - Phone:631-477-6696
Practice Address - Fax:631-477-6695
Is Sole Proprietor?:No
Enumeration Date:2008-07-10
Last Update Date:2011-10-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY1283972084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
1265696108Medicare PIN