Provider Demographics
NPI:1578721346
Name:BECTON, LAUREN JENNIFER (MD)
Entity type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:JENNIFER
Last Name:BECTON
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 1:24 E NEWFIELD WAY
Mailing Address - Street 2:
Mailing Address - City:BALA CYNWYD
Mailing Address - State:PA
Mailing Address - Zip Code:19004-2322
Mailing Address - Country:US
Mailing Address - Phone:919-451-6465
Mailing Address - Fax:
Practice Address - Street 1:550 S GODDARD BLVD
Practice Address - Street 2:
Practice Address - City:KING OF PRUSSIA
Practice Address - State:PA
Practice Address - Zip Code:19406-2922
Practice Address - Country:US
Practice Address - Phone:267-425-8740
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-29
Last Update Date:2024-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD471932208000000X
SCMD4719322080P0210X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2080P0210XAllopathic & Osteopathic PhysiciansPediatricsPediatric Nephrology