Provider Demographics
NPI:1811147184
Name:LASKY, DENISE SHARON
Entity type:Individual
Prefix:MS
First Name:DENISE
Middle Name:SHARON
Last Name:LASKY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 WINCHESTER DR
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:NY
Mailing Address - Zip Code:10950-3910
Mailing Address - Country:US
Mailing Address - Phone:845-774-7558
Mailing Address - Fax:
Practice Address - Street 1:53 ROUTE 17K
Practice Address - Street 2:
Practice Address - City:NEWBURGH
Practice Address - State:NY
Practice Address - Zip Code:12550-3922
Practice Address - Country:US
Practice Address - Phone:845-566-3419
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-23
Last Update Date:2008-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0721271041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical