Individual
JASON ROBERT STEPHANSKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
335 BRIGHTON AVE STE 200, PORTLAND, ME 04102-2362
(207) 662-8600
Mailing address
1130 WASHINGTON ST, WHITMAN, MA 02382-1236
(781) 710-0072
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA2392
BOARD OF LICENSURE IN MEDICINE
ME
Enumeration date
06/10/2022
Last updated
08/22/2022
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