Provider Demographics
NPI:1851398812
Name:LAL, RASIK B (MD)
Entity Type:Individual
Prefix:
First Name:RASIK
Middle Name:B
Last Name:LAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:119 S BURROWES ST
Mailing Address - Street 2:SUITE # 604
Mailing Address - City:STATE COLLEGE
Mailing Address - State:PA
Mailing Address - Zip Code:16801-3863
Mailing Address - Country:US
Mailing Address - Phone:814-861-1233
Mailing Address - Fax:
Practice Address - Street 1:119 S BURROWES ST
Practice Address - Street 2:SUITE # 604
Practice Address - City:STATE COLLEGE
Practice Address - State:PA
Practice Address - Zip Code:16801-3863
Practice Address - Country:US
Practice Address - Phone:814-861-1233
Practice Address - Fax:413-254-0481
Is Sole Proprietor?:No
Enumeration Date:2005-07-06
Last Update Date:2008-04-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD036874L2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAC03146Medicare UPIN