Provider Demographics
NPI:1184659930
Name:LASKY, ELLIOT F (OD)
Entity Type:Individual
Prefix:DR
First Name:ELLIOT
Middle Name:F
Last Name:LASKY
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:505 W HOLLIS ST
Mailing Address - Street 2:
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03062-1358
Mailing Address - Country:US
Mailing Address - Phone:603-882-0311
Mailing Address - Fax:603-386-0046
Practice Address - Street 1:505 W HOLLIS ST
Practice Address - Street 2:
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03062-1358
Practice Address - Country:US
Practice Address - Phone:603-882-0311
Practice Address - Fax:603-386-0046
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2020-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0320152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NHNH7878Medicaid
T86101Medicare UPIN
NH7878Medicare ID - Type Unspecified