Provider Demographics
NPI:1912062209
Name:BESLOW, LAUREN ALLEGRA (MD, MSCE)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:ALLEGRA
Last Name:BESLOW
Suffix:
Gender:F
Credentials:MD, MSCE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:P.O. BOX 208064
Mailing Address - Street 2:SECTION OF NEUROLOGY,YALE UNIVERSITY SCHOOL OF MEDICINE
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06520
Mailing Address - Country:US
Mailing Address - Phone:203-785-4641
Mailing Address - Fax:
Practice Address - Street 1:300 CEDAR ST
Practice Address - Street 2:SECTION OF NEUROLOGY,YALE UNIVERSITY SCHOOL OF MEDICINE
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06519-1612
Practice Address - Country:US
Practice Address - Phone:203-785-4641
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-27
Last Update Date:2015-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT1818742084N0400X
PAMD4267682084N0402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child Neurology
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology