Provider Demographics
NPI:1104836154
Name:GARINO, LUCIA ASTRID (MD)
Entity Type:Individual
Prefix:DR
First Name:LUCIA
Middle Name:ASTRID
Last Name:GARINO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2550 UNIVERSITY AVE W STE 110N
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55114-2001
Mailing Address - Country:US
Mailing Address - Phone:651-602-5309
Mailing Address - Fax:651-222-6786
Practice Address - Street 1:11850 BLACKFOOT ST NW
Practice Address - Street 2:SUITE 100
Practice Address - City:COON RAPIDS
Practice Address - State:MN
Practice Address - Zip Code:55433-2598
Practice Address - Country:US
Practice Address - Phone:763-721-2100
Practice Address - Fax:763-721-2190
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2017-11-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN41470207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN1022445OtherPREFERRED ONE
MN3611173OtherMEDICA
MN410729979OtherCOMMERCIAL
MN3611173OtherSELECT CARE
MNHP29973OtherHEALTH PARTNERS
MN452223100Medicaid
MN124399OtherUCARE
MN13D68GAOtherBLUE SHIELD
MN3611173OtherMEDICA
MN410729979OtherCOMMERCIAL