Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081P2900X | Pain Medicine | 282822 | NY |
NPI | 1316227325 |
---|---|
Provider Name | Peter C Lascarides |
First Address | Riverhead, NY 11901-2146 |
Second Address | Riverhead, NY 11901-2146 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/08/2011 |
Last Update Date | 02/03/2020 |