Provider Demographics
NPI:1366097271
Name:MONASHKIN, LANA (MMSC, PA-C)
Entity type:Individual
Prefix:
First Name:LANA
Middle Name:
Last Name:MONASHKIN
Suffix:
Gender:F
Credentials:MMSC, PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:939 STATE ST APT C
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06511-7318
Mailing Address - Country:US
Mailing Address - Phone:602-380-9294
Mailing Address - Fax:
Practice Address - Street 1:939 STATE ST APT C
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06511-7318
Practice Address - Country:US
Practice Address - Phone:602-380-9294
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-07
Last Update Date:2019-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT4533363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant