Provider Demographics
NPI:1568642387
Name:LASCALA, JANELLE (PA-C)
Entity Type:Individual
Prefix:MS
First Name:JANELLE
Middle Name:
Last Name:LASCALA
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:JANELLE
Other - Middle Name:
Other - Last Name:LASCALA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PA-C
Mailing Address - Street 1:100 PORT WASHINGTON BLVD
Mailing Address - Street 2:SAINT FRANCIS HOSPITAL
Mailing Address - City:ROSLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11576
Mailing Address - Country:US
Mailing Address - Phone:516-562-6512
Mailing Address - Fax:
Practice Address - Street 1:100 PORT WASHINGTON BLVD
Practice Address - Street 2:SAINT FRANCIS HOSPITAL
Practice Address - City:ROSLYN
Practice Address - State:NY
Practice Address - Zip Code:11576
Practice Address - Country:US
Practice Address - Phone:516-562-6512
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-08
Last Update Date:2018-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY23 012064363A00000X
NY012064363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant