Basic Information
Provider Information
NPI: 1003398496
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MICHALSKI
FirstName: LORI
MiddleName: MARIE
NamePrefix:  
NameSuffix:  
Credential: CRNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1180 MIFFLIN RD
Address2:  
City: PITTSBURGH
State: PA
PostalCode: 152072010
CountryCode: US
TelephoneNumber: 2155149498
FaxNumber: 8565471008
Practice Location
Address1: 600 CLEMENTS BRIDGE RD
Address2:  
City: BARRINGTON
State: NJ
PostalCode: 080071814
CountryCode: US
TelephoneNumber: 8565478000
FaxNumber: 8565471008
Other Information
ProviderEnumerationDate: 08/31/2018
LastUpdateDate: 08/31/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000XSP019170PAY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


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