Provider Demographics
NPI:1699203034
Name:TAINSH, LAUREL TILLINGHAST (MD, MHS)
Entity Type:Individual
Prefix:
First Name:LAUREL
Middle Name:TILLINGHAST
Last Name:TAINSH
Suffix:
Gender:F
Credentials:MD, MHS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 MONTVALE AVE STE 501
Mailing Address - Street 2:
Mailing Address - City:STONEHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02180-3567
Mailing Address - Country:US
Mailing Address - Phone:781-279-4418
Mailing Address - Fax:
Practice Address - Street 1:1 MONTVALE AVE STE 501
Practice Address - Street 2:
Practice Address - City:STONEHAM
Practice Address - State:MA
Practice Address - Zip Code:02180-3567
Practice Address - Country:US
Practice Address - Phone:781-279-4418
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-30
Last Update Date:2021-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA287653207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology