MEDICARE: MS. SUSAN CZARNECKI LASKER FNP

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	363LF0000X	Family Nurse Practitioner	F330636	NY

General Provider Information

NPI Number	:	1083651616
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SUSAN CZARNECKI LASKER FNP

Provider Business Mailing Address
First Line	:	62 RIVERVIEW RD
Second Line	:
City	:	CLIFTON PARK
State	:	NY
Zip	:	12065-6813
Country	:	US
Telephone Number	:	518-348-1030
Fax Number	:

Provider Business Practice Location Address
First Line	:	326 S PEARL ST
Second Line	:
City	:	ALBANY
State	:	NY
Zip	:	12202-1914
Country	:	US
Telephone Number	:	518-449-0100
Fax Number	:	518-463-8580

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

Provider Enumeration Date	:	06/01/2006
Last Update Date	:	07/21/2022

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