Individual
MR. EDMUND L LASEK JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
228 GENESEE ST, UTICA, NY 13502
(315) 738-1754
Mailing address
228 GENESEE ST, UTICA, NY 13502
(315) 738-1754
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
4665
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01486488
—
NY
Enumeration date
10/24/2006
Last updated
07/08/2007
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