Provider Demographics
NPI:1821016650
Name:LASH, STEPHANIE ROSE (MD)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:ROSE
Last Name:LASH
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:4 GLEN COVE DR
Mailing Address - Street 2:SUITE 102
Mailing Address - City:ROCKPORT
Mailing Address - State:ME
Mailing Address - Zip Code:04856-4235
Mailing Address - Country:US
Mailing Address - Phone:207-593-5757
Mailing Address - Fax:207-593-5357
Practice Address - Street 1:4 GLEN COVE DR
Practice Address - Street 2:SUITE 102
Practice Address - City:ROCKPORT
Practice Address - State:ME
Practice Address - Zip Code:04856-4235
Practice Address - Country:US
Practice Address - Phone:207-593-5757
Practice Address - Fax:207-593-5357
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2012-01-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
ME0133092084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MEF15925Medicare UPIN