Individual ProviderLauren IckenStudent in an Organized Health Care Education/Training ProgramStudent, Health CarePractice Address47 New Scotland Ave, Dept. Of Emergency Medicine, Albany, NY 12208(518) 262-3593PECOS EnrollmentBased on the most recent information from CMS, provider Lauren Icken is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 3 days ago.Profile DetailsProvider ID1255968970Provider TypeIndividualFull NameIcken, LaurenCredentialMDGenderFemaleSole ProprietorNoEnumeration Date3/24/2020Last Updated3/24/2020Contact InformationPractice LocationPractice Address47 New Scotland Ave, Dept. Of Emergency Medicine, Albany, NY 12208Phone(518) 262-3593FaxUnlisted FaxMailing LocationMailing Address47 New Scotland Ave, Dept. Of Emergency Medicine, Albany, NY 12208PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode390200000XPrimaryDescriptionStudent in an Organized Health Care Education/Training ProgramStudent, Health CareLicense64314