Provider Demographics
NPI:1225212541
Name:CHESTER A. LASKOSKI, D.P.M
Entity Type:Organization
Organization Name:CHESTER A. LASKOSKI, D.P.M
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHESTER
Authorized Official - Middle Name:A
Authorized Official - Last Name:LASKOSKI
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:717-354-6100
Mailing Address - Street 1:430 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NEW HOLLAND
Mailing Address - State:PA
Mailing Address - Zip Code:17557-1144
Mailing Address - Country:US
Mailing Address - Phone:717-354-6100
Mailing Address - Fax:
Practice Address - Street 1:430 W MAIN ST
Practice Address - Street 2:
Practice Address - City:NEW HOLLAND
Practice Address - State:PA
Practice Address - Zip Code:17557-1144
Practice Address - Country:US
Practice Address - Phone:717-354-6100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-21
Last Update Date:2007-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC001953L213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0481810001Medicare NSC