Lasala, Johanna

Lasala, Johanna is an individual health care provider with primary practice located at 240 Indian River Rd Bld A Ste 1, Orange CT 06477-3649. She recently has only one registered license in Allopathic & Osteopathic Physicians / Hematology & Oncology, which is considered as her primary health care specialty. Lasala, Johanna can be contacted via phone (203) 795-1664.

Contact Information

Primary practice address
240 Indian River Rd Bld A Ste 1 Orange CT 06477-3649
Phone: (203) 795-1664
Fax: (203) 795-1665
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Hematology & Oncology 207RH0003X 035143 Connecticut

Profile Details

NPI number 1932148848
LBN Legal business name Lasala, Johanna
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 6th, 2006
Last updated Jan 28th, 2013 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1932148848 NPPES
Connecticut MEDICAID 001351436

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