Provider Demographics
NPI:1518286590
Name:KASOFSKY, LAWRENCE (PHARMACIST)
Entity Type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:
Last Name:KASOFSKY
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:458 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:MONTICELLO
Mailing Address - State:NY
Mailing Address - Zip Code:12701-1732
Mailing Address - Country:US
Mailing Address - Phone:845-794-5757
Mailing Address - Fax:845-795-3570
Practice Address - Street 1:458 BROADWAY
Practice Address - Street 2:
Practice Address - City:MONTICELLO
Practice Address - State:NY
Practice Address - Zip Code:12701-1732
Practice Address - Country:US
Practice Address - Phone:845-794-5757
Practice Address - Fax:845-795-3570
Is Sole Proprietor?:No
Enumeration Date:2010-05-28
Last Update Date:2010-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY024380-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist