Provider Demographics
NPI:1922172253
Name:HANACHE AND LASOTA MD ASSOC
Entity Type:Organization
Organization Name:HANACHE AND LASOTA MD ASSOC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSOCIATE
Authorized Official - Prefix:MRS
Authorized Official - First Name:JEANNE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:HANACHE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:610-296-5022
Mailing Address - Street 1:PO BOX 1003
Mailing Address - Street 2:11 HORSESHOE LANE
Mailing Address - City:PAOLI
Mailing Address - State:PA
Mailing Address - Zip Code:19301-0909
Mailing Address - Country:US
Mailing Address - Phone:610-296-5022
Mailing Address - Fax:610-640-4598
Practice Address - Street 1:11 HORSESHOE LANE
Practice Address - Street 2:
Practice Address - City:PAOLI
Practice Address - State:PA
Practice Address - Zip Code:19301-0909
Practice Address - Country:US
Practice Address - Phone:610-296-5022
Practice Address - Fax:610-640-4598
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-20
Last Update Date:2008-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD007091E2084P0800X
PAMD008076E2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1025167Medicaid
PA1025167Medicaid
PA180411Medicare PIN
037622GH9Medicare ID - Type Unspecified