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NPI Code Detail

MEDICARE: DR. RAYMOND JAMES LASKO D.C.

MEDICARE: DR. RAYMOND JAMES LASKO D.C.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111N00000XChiropractor2670NJ

General Provider Information

NPI Number : 1114950177
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RAYMOND JAMES LASKO D.C.
Provider Business Mailing Address
First Line : 192 SPRAGUE AVE
Second Line :
City : WEST CREEK
State : NJ
Zip : 08092-9321
Country : US
Telephone Number : 609-294-0350
Fax Number :
Provider Business Practice Location Address
First Line : 1700 MADISON AVE
Second Line :
City : LAKEWOOD
State : NJ
Zip : 08701-1253
Country : US
Telephone Number : 732-363-7900
Fax Number : 732-363-9341
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/09/2006
Last Update Date : 07/08/2007

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