MEDICARE: CHESTER A. 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	213E00000X	Podiatrist	SC001953L	PA

General Provider Information

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

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

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

Authorized Official
Title or Position	:	OWNER
Name	:	DR. CHESTER A. LASKOSKI
Credential	:	DPM
Telephone Number	:	717-354-6100

Provider Enumeration Date	:	12/21/2007
Last Update Date	:	12/21/2007

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