Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN0400X | Neurology | DC-005889-L | PA |
NPI | 1275750069 |
---|---|
Provider Name | Dr. Kevin Joseph Lasko |
First Address | Lancaster, PA 17602-3398 |
Second Address | Lancaster, PA 17602-3398 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/04/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000723 | (02) | PA |