Basic Information
| Provider Information | |||||||||
| NPI: | 1992815765 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | LASKIN & HIGGINS INTERNAL MEDICINE LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 400 GROVE RD | ||||||||
| Address2: | PO BOX 37 | ||||||||
| City: | THOROFARE | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 080860037 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8568458010 | ||||||||
| FaxNumber: | 8568459398 | ||||||||
| Practice Location | |||||||||
| Address1: | 400 GROVE RD | ||||||||
| Address2: | |||||||||
| City: | THOROFARE | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 080860037 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8568458010 | ||||||||
| FaxNumber: | 8568459398 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/30/2006 | ||||||||
| LastUpdateDate: | 06/25/2009 | ||||||||
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| AuthorizedOfficialLastName: | LASKIN | ||||||||
| AuthorizedOfficialFirstName: | DAVID | ||||||||
| AuthorizedOfficialMiddleName: | A | ||||||||
| AuthorizedOfficialTitleorPosition: | PARTNER | ||||||||
| AuthorizedOfficialTelephone: | 8568458010 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 0382197001 | 01 | AMERIHEALTH | OTHER | 3185001 | 05 | NJ | MEDICAID |