Healthcare Provider Details

I. General information

NPI: 1700971959
Provider Name (Legal Business Name): LORNA STANLEY M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 04/28/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

905 HERRONTOWN RD PRINCETON HOUSE BEHAVIORAL HEALTH
PRINCETON NJ
08540-1901
US

IV. Provider business mailing address

4 PRINCESS RD SUITE #207
LAWRENCEVILLE NJ
08648-2322
US

V. Phone/Fax

Practice location:
  • Phone: 609-497-3300
  • Fax: 609-497-3370
Mailing address:
  • Phone: 609-243-0445
  • Fax: 609-844-1092

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number25MA07549600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: