Healthcare Provider Details

I. General information

NPI: 1013923374
Provider Name (Legal Business Name): CHESTER ALBERT LASKOSKI D.P.M.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: CHESTER ALBERT LASKOSKI D.P.M.

II. Dates (important events)

Enumeration Date: 07/31/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

430 W MAIN ST SUITE 3
NEW HOLLAND PA
17557-1144
US

IV. Provider business mailing address

430 W MAIN ST SUITE 3
NEW HOLLAND PA
17557-1144
US

V. Phone/Fax

Practice location:
  • Phone: 717-354-6100
  • Fax: 717-354-2902
Mailing address:
  • Phone: 717-354-6100
  • Fax: 717-354-2902

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License NumberSC001953L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: