Provider Demographics
NPI:1972837425
Name:LANASA, TERESA CATHERINE (PA-C)
Entity type:Individual
Prefix:
First Name:TERESA
Middle Name:CATHERINE
Last Name:LANASA
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:241 FREEPORT RD
Mailing Address - Street 2:
Mailing Address - City:ASPINWALL
Mailing Address - State:PA
Mailing Address - Zip Code:15215-3035
Mailing Address - Country:US
Mailing Address - Phone:412-784-1606
Mailing Address - Fax:412-784-8225
Practice Address - Street 1:241 FREEPORT RD
Practice Address - Street 2:
Practice Address - City:ASPINWALL
Practice Address - State:PA
Practice Address - Zip Code:15215-3035
Practice Address - Country:US
Practice Address - Phone:412-784-1606
Practice Address - Fax:412-784-8225
Is Sole Proprietor?:No
Enumeration Date:2009-09-30
Last Update Date:2009-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA053962363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant