MEDICARE: GABRIELA LASKY D.D.S

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	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1083347876
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GABRIELA LASKY D.D.S

Provider Business Mailing Address
First Line	:	1815 YONGE ST
Second Line	:
City	:	TORONTO
State	:	ONTARIO
Zip	:	M4T2A4
Country	:	CA
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1824 MADISON AVENUE
Second Line	:
City	:	NEW YORK CITY
State	:	NY
Zip	:	10035
Country	:	US
Telephone Number	:	212-241-0300
Fax Number	:

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

Provider Enumeration Date	:	07/08/2022
Last Update Date	:	03/01/2023

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