Provider Demographics
NPI:1366417891
Name:PERRY, LINA
Entity type:Individual
Prefix:
First Name:LINA
Middle Name:
Last Name:PERRY
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 1:110 N MAIN ST
Mailing Address - Street 2:UPMC HORIZON, DEPARTMENT OF PATHOLOGY
Mailing Address - City:GREENVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:16125-1726
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:110 N MAIN ST
Practice Address - Street 2:UPMC HORIZON, DEPARTMENT OF PATHOLOGY
Practice Address - City:GREENVILLE
Practice Address - State:PA
Practice Address - Zip Code:16125-1726
Practice Address - Country:US
Practice Address - Phone:724-588-2100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-20
Last Update Date:2021-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD060586L174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAG80973Medicare UPIN
PA019691LRDMedicare ID - Type Unspecified