Basic Information
| Provider Information | |||||||||
| NPI: | 1033172564 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LASICH | ||||||||
| FirstName: | LORI | ||||||||
| MiddleName: | ANN | ||||||||
| NamePrefix: | MRS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | NURSE PRACTIONER | ||||||||
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| Mailing Information | |||||||||
| Address1: | 300 HALKET ST | ||||||||
| Address2: | |||||||||
| City: | PITTSBURGH | ||||||||
| State: | PA | ||||||||
| PostalCode: | 152133180 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4126414530 | ||||||||
| FaxNumber: | 4126411085 | ||||||||
| Practice Location | |||||||||
| Address1: | 300 HALKET ST | ||||||||
| Address2: | |||||||||
| City: | PITTSBURGH | ||||||||
| State: | PA | ||||||||
| PostalCode: | 152133180 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4126414530 | ||||||||
| FaxNumber: | 4126411085 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/07/2006 | ||||||||
| LastUpdateDate: | 08/06/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/06/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | LICVP006402M | PA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.