MEDICARE: ROBERT JOSEPH LASKOWSKI M.D., M.B.A.

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
1	207RG0300X	Geriatric Medicine (Internal Medicine) Physician	C1-0006993	DE

General Provider Information

NPI Number	:	1477534907
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT JOSEPH LASKOWSKI M.D., M.B.A.

Provider Business Mailing Address
First Line	:	501 W 14TH ST
Second Line	:
City	:	WILMINGTON
State	:	DE
Zip	:	19801-1013
Country	:	US
Telephone Number	:	302-428-2570
Fax Number	:	302-428-2540

Provider Business Practice Location Address
First Line	:	501 W 14TH ST
Second Line	:
City	:	WILMINGTON
State	:	DE
Zip	:	19801-1013
Country	:	US
Telephone Number	:	302-428-2570
Fax Number	:	302-428-2540

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/10/2005
Last Update Date	:	07/08/2007

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