Organization
DERMATOLOGY LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN JOSEPH LASKAS JR. M.D. (PRESIDENT)
(610) 566-7111
Entity
Organization
Contact information
Practice address
101 CHESLEY DR, SUITE 100, MEDIA, PA 19063-1761
(610) 566-7111
(610) 891-6735
Mailing address
101 CHESLEY DR, SUITE 100, MEDIA, PA 19063-1761
(610) 566-7111
(610) 891-6735
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
827796
BLUE SHIELD
PA
Enumeration date
05/23/2006
Last updated
06/24/2010
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