Provider Demographics
NPI:1073752416
Name:STABINSKI, LARISSA LEONA
Entity Type:Individual
Prefix:DR
First Name:LARISSA
Middle Name:LEONA
Last Name:STABINSKI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:960 FELL ST
Mailing Address - Street 2:UNIT 950
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21231-3520
Mailing Address - Country:US
Mailing Address - Phone:202-372-7316
Mailing Address - Fax:
Practice Address - Street 1:600 NORTH WOLFE STREET
Practice Address - Street 2:CARNEIGE 346
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21287
Practice Address - Country:US
Practice Address - Phone:410-614-6045
Practice Address - Fax:410-955-7733
Is Sole Proprietor?:No
Enumeration Date:2009-02-09
Last Update Date:2009-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD973968207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine