Healthcare Provider Details

I. General information

NPI: 1548827314
Provider Name (Legal Business Name): LAURIE-ANN PANTON MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: LAURIE-ANN STEPHENSON MD

II. Dates (important events)

Enumeration Date: 05/28/2019
Last Update Date: 10/06/2025
Certification Date: 10/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

506 LENOX AVE
NEW YORK NY
10037-1802
US

IV. Provider business mailing address

210 E 121ST ST APT 7D
NEW YORK NY
10035-3053
US

V. Phone/Fax

Practice location:
  • Phone: 212-939-4019
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0206X
TaxonomyPediatric Gastroenterology Physician
License Number35.154699
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: