Provider Demographics
NPI:1013723741
Name:DOVER, LASHAWN G
Entity type:Individual
Prefix:
First Name:LASHAWN
Middle Name:G
Last Name:DOVER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:224 HIGHLAND BLVD APT 614
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11207-1966
Mailing Address - Country:US
Mailing Address - Phone:929-667-9208
Mailing Address - Fax:
Practice Address - Street 1:224 HIGHLAND BLVD APT 614
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11207-1966
Practice Address - Country:US
Practice Address - Phone:929-667-9208
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-07
Last Update Date:2024-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372500000XNursing Service Related ProvidersChore Provider