Healthcare Provider Details

I. General information

NPI: 1619906484
Provider Name (Legal Business Name): OBSTETRICS & GYNECOLOGY ASSOCIATES OF FREDERICKSBURG, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/02/2006
Last Update Date: 12/20/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4103 LAFAYETTE BLVD
FREDERICKSBURG VA
22408-4274
US

IV. Provider business mailing address

4103 LAFAYETTE BLVD
FREDERICKSBURG VA
22408-4274
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 Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: OSCAR LASERNA
Title or Position: PHYSICIAN/OWNER
Credential: M.D.
Phone: 540-898-0295