Provider Demographics
NPI:1821786229
Name:LASZLOCZKY, JOHANNA (FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:JOHANNA
Middle Name:
Last Name:LASZLOCZKY
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 SATURN CT
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND LAKES
Mailing Address - State:NJ
Mailing Address - Zip Code:07422-9734
Mailing Address - Country:US
Mailing Address - Phone:973-856-3777
Mailing Address - Fax:
Practice Address - Street 1:6 SATURN CT
Practice Address - Street 2:
Practice Address - City:HIGHLAND LAKES
Practice Address - State:NJ
Practice Address - Zip Code:07422-9734
Practice Address - Country:US
Practice Address - Phone:973-856-3777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-25
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR12459300363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily