Basic Information
Provider Information
NPI: 1154654721
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: TASCI
FirstName: LORI
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: CRNA
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: PAULOWSKEY
OtherFirstName: LORI
OtherMiddleName: ANN
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential: CRNA
OtherLastNameType: 1
Mailing Information
Address1: 1245 S CEDAR CREST BLVD STE 301
Address2:  
City: ALLENTOWN
State: PA
PostalCode: 181036258
CountryCode: US
TelephoneNumber: 6104029099
FaxNumber: 6104029029
Practice Location
Address1: 1200 S CEDAR CREST BLVD
Address2:  
City: ALLENTOWN
State: PA
PostalCode: 181036202
CountryCode: US
TelephoneNumber: 6104029099
FaxNumber: 6104029029
Other Information
ProviderEnumerationDate: 09/14/2009
LastUpdateDate: 01/19/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163W00000XRN554479PAN Nursing Service ProvidersRegistered Nurse 
367500000X082998PAY Physician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered 

ID Information
IDTypeStateIssuerDescription
12952301PAGEISINGEROTHER
920744401PAAETNAOTHER
158622801PAGATEWAYOTHER
5008851001PACAPITAL ADVANTAGEOTHER
102780941000105PA MEDICAID
374718300001PAIBCOTHER
213673201PAHIGHMARKOTHER
213673201PAFIRST PRIORITYOTHER
1200354301PACAQHOTHER


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