Basic Information
Provider Information
NPI: 1720135288
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FURLANI
FirstName: LISA
MiddleName: A
NamePrefix:  
NameSuffix:  
Credential: CRNA
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: HASTINGS
OtherFirstName: LISA
OtherMiddleName: A
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential: CRNA
OtherLastNameType: 1
Mailing Information
Address1: 908 NIAGARA FALLS BLVD STE 208
Address2:  
City: NORTH TONAWANDA
State: NY
PostalCode: 141202019
CountryCode: US
TelephoneNumber: 7166923302
FaxNumber: 7166924342
Practice Location
Address1: 462 GRIDER ST
Address2:  
City: BUFFALO
State: NY
PostalCode: 142153098
CountryCode: US
TelephoneNumber: 7168983436
FaxNumber:  
Other Information
ProviderEnumerationDate: 01/05/2007
LastUpdateDate: 04/24/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
367500000X389924NYY Physician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered 

No ID Information.


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