Provider Demographics
NPI:1457373037
Name:KEIZER-NATHAN, LAUREN RENEE (DDS)
Entity Type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:RENEE
Last Name:KEIZER-NATHAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 W 23RD ST
Mailing Address - Street 2:APARTMENT #842
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10010-5283
Mailing Address - Country:US
Mailing Address - Phone:646-808-4501
Mailing Address - Fax:
Practice Address - Street 1:450 PARK AVE S
Practice Address - Street 2:SUITE 200
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-7320
Practice Address - Country:US
Practice Address - Phone:212-725-6001
Practice Address - Fax:212-725-6090
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2007-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY052030122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist