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Individual

DR. MARY THERESA CHASKO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
10810 CONNECTICUT AVE, KAISER PERMANENTE KENSINGTON MEDICAL CENTER, KENSINGTON, MD 20895-2138
(301) 929-7100
Mailing address
2101 E JEFFERSON ST, KAISER PERMANENTE MEDICARE ENROLLMENT, ROCKVILLE, MD 20852-4908
(301) 816-2424

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
0101250932
VA
207L00000X
Anesthesiology Physician
Primary
D73405
MD
207L00000X
Anesthesiology Physician
MD040259
DC
207L00000X
Anesthesiology Physician
MD431249
PA
207LP2900X
Pain Medicine (Anesthesiology) Physician
MD431249
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
002056193
HIGHMARK BLUE SHIELD
PA
01
050514
MEDICARE GROUP PIN
PA
05
102165970 0001
PA
01
120420418
DEPT OF LABOR
PA
01
1569261
GATEWAY (AFC)
PA
01
1581407
GATEWAY (PMFC)
PA
01
1885935
AETNA HMO (AFC)
PA
01
2183091
MAMSI
PA
01
245630
UNISON (AFC)
PA
01
25-1716306
MULTIPLAN/PHCS
PA
01
259792
UNISON (PMFC)
PA
01
50078618
CAPITAL BLUECROSS
PA
01
6802733
AETNA HMO (PMFC)
PA
01
9695183
AETNA NON-HMO
PA
01
G920-0096/85XWCU
CAREFIRST (AFC)
PA
01
G920-0096/914765-04
CAREFIRST (PMFC)
PA
01
MD431249
MEDICAL LICENSE
PA
01
P00618655
RAILROAD MEDICARE
PA
01
PEARL
HEALTH AMERICA
PA
Enumeration date
05/10/2007
Last updated
03/07/2023
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