Provider Demographics
NPI:1750566006
Name:ROBERT D LAFSKY MD PC
Entity type:Organization
Organization Name:ROBERT D LAFSKY MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JEAN
Authorized Official - Middle Name:C
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-858-3060
Mailing Address - Street 1:44055 RIVERSIDE PKWY
Mailing Address - Street 2:SUITE 226
Mailing Address - City:LEESBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20176-5179
Mailing Address - Country:US
Mailing Address - Phone:703-858-3060
Mailing Address - Fax:703-858-3061
Practice Address - Street 1:44055 RIVERSIDE PKWY
Practice Address - Street 2:SUITE 226
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20176-5179
Practice Address - Country:US
Practice Address - Phone:703-858-3060
Practice Address - Fax:703-858-3061
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ROBERT D LAFSKY MD
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-01-07
Last Update Date:2008-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101031988174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty