Healthcare Provider Details

I. General information

NPI: 1982664587
Provider Name (Legal Business Name): LAWRENCE M EPSTEIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2006
Last Update Date: 01/27/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

255 ROUTE 108
SOMERSWORTH NH
03878-1543
US

IV. Provider business mailing address

255 ROUTE 108
SOMERSWORTH NH
03878-1543
US

V. Phone/Fax

Practice location:
  • Phone: 603-692-3166
  • Fax: 603-692-3168
Mailing address:
  • Phone: 603-692-3166
  • Fax: 603-692-3168

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RA0401X
TaxonomyAddiction Medicine (Internal Medicine) Physician
License Number16904
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: