Provider Demographics
NPI:1336283464
Name:LASKOWSKI, ROBERT A (RPH)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:A
Last Name:LASKOWSKI
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:448 CHAMBERLAIN AVE
Mailing Address - Street 2:
Mailing Address - City:PATERSON
Mailing Address - State:NJ
Mailing Address - Zip Code:07522-1009
Mailing Address - Country:US
Mailing Address - Phone:973-942-8296
Mailing Address - Fax:973-942-1213
Practice Address - Street 1:448 CHAMBERLAIN AVE
Practice Address - Street 2:
Practice Address - City:PATERSON
Practice Address - State:NJ
Practice Address - Zip Code:07522-1009
Practice Address - Country:US
Practice Address - Phone:973-942-8296
Practice Address - Fax:973-942-1213
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI01409100183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist