Basic Information
Provider Information
NPI: 1245627223
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LAPIN
FirstName: JENNIFER
MiddleName: ELAINE
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1 CHILDRENS PLZ
Address2:  
City: DAYTON
State: OH
PostalCode: 454041873
CountryCode: US
TelephoneNumber: 9376413000
FaxNumber:  
Practice Location
Address1: 1010 VALLEY ST
Address2:  
City: DAYTON
State: OH
PostalCode: 454042070
CountryCode: US
TelephoneNumber: 9376414000
FaxNumber: 9376414500
Other Information
ProviderEnumerationDate: 04/17/2015
LastUpdateDate: 10/18/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 10/18/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2080P0006X35.133345OHY Allopathic & Osteopathic PhysiciansPediatricsDevelopmental – Behavioral Pediatrics

No ID Information.


Home