Provider Demographics
NPI:1528401940
Name:MALTESE, LAUREN M (MD)
Entity type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:M
Last Name:MALTESE
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 1:362 N BROADWAY
Mailing Address - Street 2:SECOND FLOOR
Mailing Address - City:SLEEPY HOLLOW
Mailing Address - State:NY
Mailing Address - Zip Code:10591-2310
Mailing Address - Country:US
Mailing Address - Phone:914-631-2070
Mailing Address - Fax:
Practice Address - Street 1:362 N BROADWAY
Practice Address - Street 2:SECOND FLOOR
Practice Address - City:SLEEPY HOLLOW
Practice Address - State:NY
Practice Address - Zip Code:10591-2310
Practice Address - Country:US
Practice Address - Phone:914-631-2070
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-16
Last Update Date:2017-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY276471207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine