Provider Demographics
NPI:1417578089
Name:LASKAR, NOZRIN (DDS)
Entity type:Individual
Prefix:
First Name:NOZRIN
Middle Name:
Last Name:LASKAR
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:79 W JERSEY ST APT 318
Mailing Address - Street 2:
Mailing Address - City:ELIZABETH
Mailing Address - State:NJ
Mailing Address - Zip Code:07202-2127
Mailing Address - Country:US
Mailing Address - Phone:201-282-1207
Mailing Address - Fax:
Practice Address - Street 1:205 ONEIDA ST
Practice Address - Street 2:
Practice Address - City:FULTON
Practice Address - State:NY
Practice Address - Zip Code:13069-1228
Practice Address - Country:US
Practice Address - Phone:315-598-3700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-05
Last Update Date:2024-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY063673122300000X
NJ22DI02833900122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist