Individual
BRIDGET M LASECKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
105 MARYS AVE, KINGSTON, NY 12401-5848
(845) 338-2500
Mailing address
PO BOX 6010, HAUPPAUGE, NY 11788-9010
(631) 232-4000
(631) 851-8225
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
010692
NY
Other
Enumeration date
08/09/2006
Last updated
07/08/2007
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