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NPI Code Detail

MEDICARE: PETER C LASCARIDES D.O.

MEDICARE: PETER C LASCARIDES 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
1390200000XStudent in an Organized Health Care Education/Training Program
22081P2900XPain Medicine (Physical Medicine & Rehabilitation) Physician282822NY

General Provider Information

NPI Number : 1316227325
Entity Type Code : Individual
Provider Name (Legal Business Name) : PETER C LASCARIDES D.O.
Provider Business Mailing Address
First Line : 400 E MAIN ST STE 181
Second Line :
City : MOUNT KISCO
State : NY
Zip : 10549-3417
Country : US
Telephone Number : 914-269-1780
Fax Number : 914-666-1401
Provider Business Practice Location Address
First Line : 400 E MAIN ST STE 181
Second Line :
City : MOUNT KISCO
State : NY
Zip : 10549-3477
Country : US
Telephone Number : 914-269-1780
Fax Number : 914-666-1401
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/22/2011
Last Update Date : 06/11/2025

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