Provider Demographics
NPI:1326008467
Name:LASCALA, SUSAN (NP)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:
Last Name:LASCALA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:78 FRENCH KING HWY
Mailing Address - Street 2:
Mailing Address - City:GILL
Mailing Address - State:MA
Mailing Address - Zip Code:01354-9718
Mailing Address - Country:US
Mailing Address - Phone:413-863-2435
Mailing Address - Fax:413-863-3735
Practice Address - Street 1:MAIN STREET
Practice Address - Street 2:DEERFIELD ACADEMY HEALTH CENTER
Practice Address - City:DEERFIELD
Practice Address - State:MA
Practice Address - Zip Code:01342
Practice Address - Country:US
Practice Address - Phone:413-774-1600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-24
Last Update Date:2008-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA170285363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily