Provider Demographics
NPI:1184154320
Name:WORGAFTIK, LAUREN GOVERMAN (MD)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:GOVERMAN
Last Name:WORGAFTIK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:HIRSH
Other - Last Name:GOVERMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PM PEDIATRICS
Mailing Address - Street 2:719 PROVIDENCE HIGHWAY
Mailing Address - City:DEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02026
Mailing Address - Country:US
Mailing Address - Phone:781-461-6767
Mailing Address - Fax:
Practice Address - Street 1:PM PEDIATRICS
Practice Address - Street 2:719 PROVIDENCE HIGHWAY
Practice Address - City:DEDHAM
Practice Address - State:MA
Practice Address - Zip Code:02026
Practice Address - Country:US
Practice Address - Phone:781-461-6767
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-19
Last Update Date:2021-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA271015208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics