Provider Demographics
NPI:1215572938
Name:SASALA, LANE
Entity Type:Individual
Prefix:
First Name:LANE
Middle Name:
Last Name:SASALA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6459 LINDSEY LN
Mailing Address - Street 2:
Mailing Address - City:EXPORT
Mailing Address - State:PA
Mailing Address - Zip Code:15632-2569
Mailing Address - Country:US
Mailing Address - Phone:724-859-5657
Mailing Address - Fax:
Practice Address - Street 1:200 LOTHROP ST
Practice Address - Street 2:SUITE 200 CWING
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15213-2536
Practice Address - Country:US
Practice Address - Phone:412-647-5909
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-18
Last Update Date:2021-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN660163163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse