Provider Demographics
NPI:1952782641
Name:LACHANCE, BRITTANY ELYCE (DO)
Entity Type:Individual
Prefix:DR
First Name:BRITTANY
Middle Name:ELYCE
Last Name:LACHANCE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:BRITTANY
Other - Middle Name:ELYCE
Other - Last Name:LANE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:100 FODEN RD STE 103
Mailing Address - Street 2:
Mailing Address - City:SOUTH PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04106-2327
Mailing Address - Country:US
Mailing Address - Phone:207-828-1122
Mailing Address - Fax:
Practice Address - Street 1:100 FODEN RD STE 103
Practice Address - Street 2:
Practice Address - City:SOUTH PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04106-2327
Practice Address - Country:US
Practice Address - Phone:207-828-1122
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-18
Last Update Date:2021-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEDO3238207RC0200X, 2084N0400X
MDH00871082084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology