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NPI Code Detail

MEDICARE: DR. ANTONIO LASORSA D.O

MEDICARE: DR. ANTONIO LASORSA D.O
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
1207PE0004XEmergency Medical Services (Emergency Medicine) Physician25MB09231000NJ

General Provider Information

NPI Number : 1093036485
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ANTONIO LASORSA D.O
Provider Business Mailing Address
First Line : 235 BERKELEY RD
Second Line :
City : RIVER EDGE
State : NJ
Zip : 07661-1213
Country : US
Telephone Number : 917-562-0020
Fax Number :
Provider Business Practice Location Address
First Line : 4 VALLEY HEALTH PLZ
Second Line :
City : PARAMUS
State : NJ
Zip : 07652-3619
Country : US
Telephone Number : 201-447-8000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/20/2010
Last Update Date : 06/02/2025

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