Provider Demographics
NPI:1043332752
Name:LASKER, SUSAN (MD)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:
Last Name:LASKER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 LYNN DR
Mailing Address - Street 2:
Mailing Address - City:ANDOVER
Mailing Address - State:NJ
Mailing Address - Zip Code:07821-3507
Mailing Address - Country:US
Mailing Address - Phone:973-347-9568
Mailing Address - Fax:973-347-9568
Practice Address - Street 1:2 CONVENT RD
Practice Address - Street 2:COLLEGE OF ST. ELIZABETH FOUNDERS HALL HEALTH SERVICE
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07960-6923
Practice Address - Country:US
Practice Address - Phone:973-290-4175
Practice Address - Fax:973-290-4182
Is Sole Proprietor?:No
Enumeration Date:2007-04-04
Last Update Date:2012-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA044690208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics