Provider Demographics
NPI:1477566750
Name:LASCANO, ARMANDO (DPM)
Entity Type:Individual
Prefix:DR
First Name:ARMANDO
Middle Name:
Last Name:LASCANO
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3741 91ST ST
Mailing Address - Street 2:
Mailing Address - City:JACKSON HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11372-7927
Mailing Address - Country:US
Mailing Address - Phone:718-779-3900
Mailing Address - Fax:718-779-1514
Practice Address - Street 1:3741 91ST ST
Practice Address - Street 2:
Practice Address - City:JACKSON HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11372-7927
Practice Address - Country:US
Practice Address - Phone:718-779-3900
Practice Address - Fax:718-779-1514
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2013-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN005303213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYPA98610Medicare PIN
NYU72450Medicare UPIN