Provider Demographics
NPI:1578627295
Name:LASKY, ERIC MICHAEL (MD)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:MICHAEL
Last Name:LASKY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:88 PIERCE RD
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:NH
Mailing Address - Zip Code:03444-8657
Mailing Address - Country:US
Mailing Address - Phone:603-563-7046
Mailing Address - Fax:
Practice Address - Street 1:452 OLD STREET RD
Practice Address - Street 2:
Practice Address - City:PETERBOROUGH
Practice Address - State:NH
Practice Address - Zip Code:03458-1263
Practice Address - Country:US
Practice Address - Phone:603-924-7191
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-20
Last Update Date:2010-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH13407207PE0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
G24919Medicare UPIN