Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080N0001X | Neonatal-Perinatal Doctor | 25MA05490900 | NJ |
NPI | 1073564712 |
---|---|
Provider Name | Dr. Michelle R Lasker |
First Address | Closter, NJ 07624-2304 |
Second Address | Ridgewood, NJ 07450-2726 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/05/2006 |
Last Update Date | 08/07/2007 |