Provider Demographics
NPI:1740674506
Name:LANSKY MEDICAL LLC
Entity type:Organization
Organization Name:LANSKY MEDICAL LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:D
Authorized Official - Last Name:LANSKY
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:413-320-2454
Mailing Address - Street 1:179 NORTHAMPTON ST STE C1
Mailing Address - Street 2:
Mailing Address - City:EASTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01027-1057
Mailing Address - Country:US
Mailing Address - Phone:413-320-2454
Mailing Address - Fax:866-551-2046
Practice Address - Street 1:179 NORTHAMPTON ST STE C1
Practice Address - Street 2:
Practice Address - City:EASTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01027-1057
Practice Address - Country:US
Practice Address - Phone:413-320-2454
Practice Address - Fax:866-551-2046
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-19
Last Update Date:2015-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty