Provider Demographics
NPI:1366892200
Name:ASHLAW, STELLA
Entity type:Individual
Prefix:MRS
First Name:STELLA
Middle Name:
Last Name:ASHLAW
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7492 SODUS CENTER RD
Mailing Address - Street 2:
Mailing Address - City:SODUS
Mailing Address - State:NY
Mailing Address - Zip Code:14551-9552
Mailing Address - Country:US
Mailing Address - Phone:315-573-5230
Mailing Address - Fax:
Practice Address - Street 1:7492 SODUS CENTER RD
Practice Address - Street 2:
Practice Address - City:SODUS
Practice Address - State:NY
Practice Address - Zip Code:14551-9552
Practice Address - Country:US
Practice Address - Phone:315-573-5230
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-21
Last Update Date:2016-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY109544164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse