Provider Demographics
NPI:1356650113
Name:LASKER, ANDREA ELAINE (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:ELAINE
Last Name:LASKER
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:74 INDIAN HILL RD
Mailing Address - Street 2:
Mailing Address - City:MOUNT KISCO
Mailing Address - State:NY
Mailing Address - Zip Code:10549-3827
Mailing Address - Country:US
Mailing Address - Phone:914-241-0953
Mailing Address - Fax:
Practice Address - Street 1:74 INDIAN HILL RD
Practice Address - Street 2:
Practice Address - City:MOUNT KISCO
Practice Address - State:NY
Practice Address - Zip Code:10549-3827
Practice Address - Country:US
Practice Address - Phone:914-241-0953
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-28
Last Update Date:2010-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012018235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY012018OtherNEW YORK STATE LICENSE