Provider Demographics
NPI:1922390160
Name:SASALA, LAURA K (PA-C)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:K
Last Name:SASALA
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:K
Other - Last Name:SCHADLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:2 HOT METAL ST
Mailing Address - Street 2:QUANTUM ONE, SUITE 001
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15203-2348
Mailing Address - Country:US
Mailing Address - Phone:412-647-3087
Mailing Address - Fax:412-432-5640
Practice Address - Street 1:532 S AIKEN AVE
Practice Address - Street 2:SUITE 400
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15232-1521
Practice Address - Country:US
Practice Address - Phone:412-623-6910
Practice Address - Fax:412-623-6911
Is Sole Proprietor?:No
Enumeration Date:2011-05-06
Last Update Date:2016-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA054583363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA2996014OtherHIGHMARK MEDICARE MANAGED CARE
PA2996014OtherHIGHMARK MEDICARE MANAGED CARE