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General NPI Number Information
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NPI Number | 1326002171
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Entity Type | Individual
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Provider Name | LARISA LASHIKER M.D.,
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Gender | Female
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Dates
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Enumeration Date | 04/17/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2061 BAY RIDGE PKWY APTB1
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City | BROOKLYN
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State | NY
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Zip | 11204-5943
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Country | US
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Telephone | 917-499-1055
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Fax | 718-491-0991
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Provider Business Mailing Address
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Address Line | 2061 BAY RIDGE PKWY APT B1
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City | BROOKLYN
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State | NY
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Zip | 11204-5943
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Country | US
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Telephone | 917-499-1055
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Fax | 718-491-0991
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 231581
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License Number State | NY
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