Basic Information
Provider Information
NPI: 1417010802
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BUDOW
FirstName: LAUREN
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 800 CROSS RIVER RD
Address2:  
City: KATONAH
State: NY
PostalCode: 105363549
CountryCode: US
TelephoneNumber: 9147638151
FaxNumber: 9147632519
Practice Location
Address1: 800 CROSS RIVER RD
Address2:  
City: KATONAH
State: NY
PostalCode: 105363549
CountryCode: US
TelephoneNumber: 9147638151
FaxNumber: 9147632519
Other Information
ProviderEnumerationDate: 12/18/2006
LastUpdateDate: 07/21/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2080A0000X172131NYN Allopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
208000000X172131NYY Allopathic & Osteopathic PhysiciansPediatrics 

No ID Information.


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