Basic Information
Provider Information
NPI: 1457350654
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MCINTOSH
FirstName: LASHAUNA
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 824804
Address2:  
City: PHILADELPHIA
State: PA
PostalCode: 191824804
CountryCode: US
TelephoneNumber: 3026913800
FaxNumber: 3027782250
Practice Location
Address1: 620 STANTON CHRISTIANA RD STE 304
Address2:  
City: NEWARK
State: DE
PostalCode: 197132135
CountryCode: US
TelephoneNumber: 3027782229
FaxNumber: 3027782250
Other Information
ProviderEnumerationDate: 07/19/2005
LastUpdateDate: 05/24/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 05/24/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207V00000XC1-0005392DEY Allopathic & Osteopathic PhysiciansObstetrics & Gynecology 

No ID Information.


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