Basic Information
| Provider Information | |||||||||
| NPI: | 1851311294 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BEARA LASIC | ||||||||
| FirstName: | LADA | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 88 YOUNG AVE | ||||||||
| Address2: | |||||||||
| City: | PELHAM | ||||||||
| State: | NY | ||||||||
| PostalCode: | 108031724 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9146361765 | ||||||||
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| Practice Location | |||||||||
| Address1: | 423 E 23RD ST | ||||||||
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| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100105011 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2126867500 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/20/2006 | ||||||||
| LastUpdateDate: | 02/23/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/23/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RN0300X | 60 235380 | NY | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Nephrology |
No ID Information.