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General NPI Number Information
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NPI Number | 1114173119
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Entity Type | Individual
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Provider Name | ELIZABETH DESMOND LASH P.T.
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Gender | Female
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Dates
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Enumeration Date | 08/11/2008
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Last Update Date | 08/11/2008
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Provider Practice Location Address
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Address Line | 1360 EGGERT RD
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City | AMHERST
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State | NY
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Zip | 14226-3354
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Country | US
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Telephone | 716-835-0417
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Fax | 716-835-2648
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Provider Business Mailing Address
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Address Line | 61 EAGLE ST
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City | WILLIAMSVILLE
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State | NY
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Zip | 14221-5552
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Country | US
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Telephone | 716-634-2217
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Fax | 716-835-2648
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 007710-1
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License Number State | NY
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