Provider Demographics
NPI:1962455485
Name:EPSHTEYN, LUDMILA (MD)
Entity Type:Individual
Prefix:DR
First Name:LUDMILA
Middle Name:
Last Name:EPSHTEYN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:85 COLUMBIAN STREET
Mailing Address - Street 2:PATHOLOGY DEPARTMENT
Mailing Address - City:WEYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02190-2416
Mailing Address - Country:US
Mailing Address - Phone:781-340-8397
Mailing Address - Fax:
Practice Address - Street 1:55 FOGG RD
Practice Address - Street 2:SOUTH SHORE HOSPITAL
Practice Address - City:SOUTH WEYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02190-2432
Practice Address - Country:US
Practice Address - Phone:781-340-8000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2016-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA59230207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3094618Medicaid
MAJ12671Medicare ID - Type Unspecified
MA3094618Medicaid