Basic Information
| Provider Information | |||||||||
| NPI: | 1043830144 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | D'SOUZA | ||||||||
| FirstName: | STEFFI | ||||||||
| MiddleName: | LORRAINE | ||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8423 MARKET STREET SUITE 101 ST. ELIZABETH BOARDMAN HOS | ||||||||
| Address2: | |||||||||
| City: | BOARDMAN | ||||||||
| State: | OH | ||||||||
| PostalCode: | 44512 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3307298700 | ||||||||
| FaxNumber: | 3307298701 | ||||||||
| Practice Location | |||||||||
| Address1: | 8423 MARKET STREET SUITE 101 ST. ELIZABETH BOARDMAN HOS | ||||||||
| Address2: | |||||||||
| City: | BOARDMAN | ||||||||
| State: | OH | ||||||||
| PostalCode: | 44512 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3307298700 | ||||||||
| FaxNumber: | 3307298701 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/20/2020 | ||||||||
| LastUpdateDate: | 08/06/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/06/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | OH | Y | Student, Health Care | Student in an Organized Health Care Education/Training Program |
No ID Information.