MEDICARE: DR. CHESTER ALBERT LASKOSKI D.P.M.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213ES0131X	Foot Surgery Podiatrist	SC001953L	PA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	480030321	OTHER	PA	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000016985	OTHER	PA	HIGHMARK BLUE SHEILD
2	18165253	OTHER	PW	WAUSAU PHC
4	01378401	OTHER	PA	CAP. BLUECROSS PPO
5	016-985	OTHER	PA	BC/BS/ PPO
6	28247	OTHER	PW	HEALTH AMERICA
7	0016985	OTHER	PA	KEYSTINE HEALTHPLAB CENTR
8	00387960000	OTHER	PA	KEYSTONE HEALTHPLAN EAST
9	0481810001	OTHER	PA	D.M.E.
10	334763	OTHER	PA	HEALTH AMERICA/HEALTH ASS
11	232073370	OTHER	RI	AMERI-HEALTH

General Provider Information

NPI Number	:	1013923374
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHESTER ALBERT LASKOSKI D.P.M.

Provider Business Mailing Address
First Line	:	430 W MAIN ST
Second Line	:	SUITE 3
City	:	NEW HOLLAND
State	:	PA
Zip	:	17557-1144
Country	:	US
Telephone Number	:	717-354-6100
Fax Number	:	717-354-2902

Provider Business Practice Location Address
First Line	:	430 W MAIN ST
Second Line	:	SUITE 3
City	:	NEW HOLLAND
State	:	PA
Zip	:	17557-1144
Country	:	US
Telephone Number	:	717-354-6100
Fax Number	:	717-354-2902

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/31/2006
Last Update Date	:	07/09/2007

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