Emilio Lastarria, MD | |
158 North St, Geneva, NY 14456-1647 | |
(315) 719-0066 | |
(315) 719-0373 |
Full Name | Emilio Lastarria |
---|---|
Gender | Male |
Speciality | Urology |
Experience | 39 Years |
Location | 158 North St, Geneva, New York |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1760587125 | NPI | - | NPPES |
271102800 | Medicaid | FL | |
P00082844 | Other | FL | RR MEDICARE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208800000X | Urology | 74228 (Wisconsin) | Primary |
208800000X | Urology | 173332 (New York) | Secondary |
Facility Name | Location | Facility Type |
---|---|---|
Marshfield Medical Center | Marshfield, WI | Hospital |
Beaver Dam Community Hospital Dba Marshfield Medical Center - Beaver Dam | Beaver dam, WI | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Mchs Hospitals Inc | 5698071173 | 1030 |
Entity Name | Marshfield Clinic Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1952347981 PECOS PAC ID: 2264345206 Enrollment ID: O20031106000590 |
Entity Name | Beaver Dam Community Hospitals Inc. |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1972188555 PECOS PAC ID: 2567370539 Enrollment ID: O20040210000666 |
Entity Name | Mchs Hospitals Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1093221434 PECOS PAC ID: 5698071173 Enrollment ID: O20180208000096 |
Mailing Address | Practice Location Address |
---|---|
Emilio Lastarria, MD 35 Mason St, Suite 214, Geneva, NY 14456-1133 Ph: (315) 230-5646 | Emilio Lastarria, MD 158 North St, Geneva, NY 14456-1647 Ph: (315) 719-0066 |
Richard Kasulke, MD Urology Medicare: Medicare Enrolled Practice Location: 200 North St, Suite 101, Geneva, NY 14456 Phone: 315-787-5100 Fax: 315-787-5108 |