Provider Demographics
NPI:1144256207
Name:LASKY, ELLA (PH D)
Entity type:Individual
Prefix:DR
First Name:ELLA
Middle Name:
Last Name:LASKY
Suffix:
Gender:F
Credentials:PH D
Other - Prefix:DR
Other - First Name:ELLA
Other - Middle Name:LASKY
Other - Last Name:CARDON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD
Mailing Address - Street 1:865 W END AVE
Mailing Address - Street 2:1A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-8401
Mailing Address - Country:US
Mailing Address - Phone:212-666-8478
Mailing Address - Fax:212-531-0896
Practice Address - Street 1:865 W END AVE
Practice Address - Street 2:1A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-8401
Practice Address - Country:US
Practice Address - Phone:212-666-8478
Practice Address - Fax:212-253-1089
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-23
Last Update Date:2013-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY4241103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYV19511OtherMEDICARE