Provider Demographics
NPI:1750124087
Name:FLOSSTIME PC
Entity type:Organization
Organization Name:FLOSSTIME PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MIKE
Authorized Official - Middle Name:
Authorized Official - Last Name:LASKOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-770-0208
Mailing Address - Street 1:22 LIBERTY DR UNIT 7M
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02210-1326
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:22 LIBERTY DR UNIT 7M
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02210-1326
Practice Address - Country:US
Practice Address - Phone:603-770-0208
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FLOSSTIME MANAGEMENT COMPANY, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-06-14
Last Update Date:2024-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental