Provider Demographics
NPI:1235127283
Name:LASERNA, ROSARIO G (MD)
Entity Type:Individual
Prefix:DR
First Name:ROSARIO
Middle Name:G
Last Name:LASERNA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4103 LAFAYETTE BLVD
Mailing Address - Street 2:OB-GYN ASSOCIATES OF FREDERICKSBURG, PC
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22580
Mailing Address - Country:US
Mailing Address - Phone:540-898-0295
Mailing Address - Fax:540-891-0225
Practice Address - Street 1:4103 LAFAYETTE BLVD
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22580
Practice Address - Country:US
Practice Address - Phone:540-898-0295
Practice Address - Fax:540-891-0225
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101026125174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA07-00534OtherUNITED HEALTHCARE
VA10947OtherHARRINGTON BENEFITS
VAC42000002OtherCAPITAL CARE
VA212496OtherMAMSI/OPTIMUM CHOICE
VA6264930Medicaid
VA1256767001OtherCIGNA
VA481136OtherAETNA
VA6264930OtherVIRGINIA PREMIER
VA10947OtherSENTARA
VA20436OtherCARENET
VA002557OtherANTHEM BLUE CROSS BLUE SH
VA541051109-02OtherSOUTHERN HEALTH
VA002557OtherANTHEM BLUE CROSS BLUE SH