| Doctor Name: | MR. AVI S. LASTER |
| NPI Number: | 1083665608 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PA |
| License Number: | 008653 |
| Business Practice Address: | 160 N Midland Ave Nyack, NY - 109601912 |
| Business Phone Number: | 8456850487 |
| Business Fax Number: | |
| Mailing Address: | 651 W Mount Pleasant Ave, LIVINGSTON |
| State: | NJ |
| Postal Code: | 070391600 |
| Phone Number: | 9732511086 |
| Fax Number: | 9732511109 |
| NPI Enumeration Date: | 05/16/2006 |
| NPI Last Update Date: | 08/04/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | 008653 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |