Basic Information
| Provider Information | |||||||||
| NPI: | 1104836154 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GARINO | ||||||||
| FirstName: | LUCIA | ||||||||
| MiddleName: | ASTRID | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2550 UNIVERSITY AVE W STE 110N | ||||||||
| Address2: | |||||||||
| City: | SAINT PAUL | ||||||||
| State: | MN | ||||||||
| PostalCode: | 551142001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6516025309 | ||||||||
| FaxNumber: | 6512226786 | ||||||||
| Practice Location | |||||||||
| Address1: | 11850 BLACKFOOT ST NW | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | COON RAPIDS | ||||||||
| State: | MN | ||||||||
| PostalCode: | 554332598 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7637212100 | ||||||||
| FaxNumber: | 7637212190 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/09/2006 | ||||||||
| LastUpdateDate: | 11/29/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RH0003X | 41470 | MN | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology & Oncology |
ID Information
| ID | Type | State | Issuer | Description | 1022445 | 01 | MN | PREFERRED ONE | OTHER | 3611173 | 01 | MN | MEDICA | OTHER | 410729979 | 01 | MN | COMMERCIAL | OTHER | 3611173 | 01 | MN | SELECT CARE | OTHER | HP29973 | 01 | MN | HEALTH PARTNERS | OTHER | 452223100 | 05 | MN | MEDICAID | 124399 | 01 | MN | UCARE | OTHER | 13D68GA | 01 | MN | BLUE SHIELD | OTHER |