Provider Demographics
NPI:1780266379
Name:LASCALA, ALLYSSA (IHP)
Entity type:Individual
Prefix:MS
First Name:ALLYSSA
Middle Name:
Last Name:LASCALA
Suffix:
Gender:F
Credentials:IHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 BUTTER LN
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19606-2131
Mailing Address - Country:US
Mailing Address - Phone:610-247-0165
Mailing Address - Fax:
Practice Address - Street 1:15 BUTTER LN
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19606-2131
Practice Address - Country:US
Practice Address - Phone:610-247-0165
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-23
Last Update Date:2021-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date: