Healthcare Provider Details

I. General information

NPI: 1235127283
Provider Name (Legal Business Name): ROSARIO G. LASERNA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 10/12/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4103 LAFAYETTE BLVD
FREDERICKSBURG VA
22580
US

IV. Provider business mailing address

4103 LAFAYETTE BLVD OB-GYN ASSOCIATES OF FREDERICKSBURG, PC
FREDERICKSBURG VA
22580
US

V. Phone/Fax

Practice location:
  • Phone: 540-898-0295
  • Fax: 540-891-0225
Mailing address:
  • Phone: 540-898-0295
  • Fax: 540-891-0225

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number0101026125
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: