Provider Demographics
NPI:1639145675
Name:LASKOWSKI, STEPHEN (DO)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:
Last Name:LASKOWSKI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 CENTER ST STE 1
Mailing Address - Street 2:
Mailing Address - City:FREDONIA
Mailing Address - State:NY
Mailing Address - Zip Code:14063-1769
Mailing Address - Country:US
Mailing Address - Phone:716-679-2233
Mailing Address - Fax:716-679-9698
Practice Address - Street 1:12 CENTER ST STE 1
Practice Address - Street 2:
Practice Address - City:FREDONIA
Practice Address - State:NY
Practice Address - Zip Code:14063-1769
Practice Address - Country:US
Practice Address - Phone:716-692-3303
Practice Address - Fax:716-692-4342
Is Sole Proprietor?:No
Enumeration Date:2006-02-28
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY185281-1207R00000X
NY185281208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01453185Medicaid
NYCC5313Medicare ID - Type Unspecified
NY01453185Medicaid
NYF72429Medicare UPIN