Provider Demographics
NPI:1295701985
Name:LASONDE, RICHARD J (MD)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:J
Last Name:LASONDE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:155 GRIFFIN RD # 1
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:NH
Mailing Address - Zip Code:03801-4125
Mailing Address - Country:US
Mailing Address - Phone:603-430-5225
Mailing Address - Fax:603-430-1230
Practice Address - Street 1:155 GRIFFIN ROAD
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03801-4125
Practice Address - Country:US
Practice Address - Phone:603-430-5225
Practice Address - Fax:603-430-1230
Is Sole Proprietor?:No
Enumeration Date:2006-02-23
Last Update Date:2008-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH9380207W00000X
ME013768207W00000X
MA151126207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME129370099Medicaid
NH180041557OtherRAILROAD MEDICARE
NH30009220Medicaid
NHDX5853Medicare PIN
NH180041557OtherRAILROAD MEDICARE
MEMM5489Medicare PIN