Healthcare Provider Details

I. General information

NPI: 1225212541
Provider Name (Legal Business Name): CHESTER A. LASKOSKI, D.P.M
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/21/2007
Last Update Date: 12/21/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

430 W MAIN ST
NEW HOLLAND PA
17557-1144
US

IV. Provider business mailing address

430 W MAIN ST
NEW HOLLAND PA
17557-1144
US

V. Phone/Fax

Practice location:
  • Phone: 717-354-6100
  • Fax:
Mailing address:
  • Phone: 717-354-6100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberSC001953L
License Number StatePA

VIII. Authorized Official

Name: DR. CHESTER A. LASKOSKI
Title or Position: OWNER
Credential: DPM
Phone: 717-354-6100