Provider Demographics
NPI:1871249086
Name:LALANI, PAISLEY SHANTA
Entity Type:Individual
Prefix:MRS
First Name:PAISLEY
Middle Name:SHANTA
Last Name:LALANI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4394 NEWCASTLE CIRCLE
Mailing Address - Street 2:LITHONIA
Mailing Address - City:GEORGIA
Mailing Address - State:GA
Mailing Address - Zip Code:30038
Mailing Address - Country:US
Mailing Address - Phone:706-885-4388
Mailing Address - Fax:
Practice Address - Street 1:4394 NEWCASTLE CIR
Practice Address - Street 2:
Practice Address - City:LITHONIA
Practice Address - State:GA
Practice Address - Zip Code:30038-3507
Practice Address - Country:US
Practice Address - Phone:706-885-4388
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-25
Last Update Date:2022-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACN0030031414251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health