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Individual

MS. JODI LASKY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
26 WESTPORT DR, WATERBURY, CT 06706-2854
(203) 565-4728
Mailing address
26 WESTPORT DR, WATERBURY, CT 06706-2854
(203) 565-4728

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
001139
CT
363AM0700X
Medical Physician Assistant
001139
CT

Other

Enumeration date
02/09/2012
Last updated
07/31/2013
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